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Sample records for contraceptive prevalence rate

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

    PubMed Central

    2013-01-01

    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

  2. Prevalence Rates of Uterine Cervical Carcinoma in situ for Women Using the Diaphragm or Contraceptive Oral Steroids*

    PubMed Central

    Melamed, Myron R.; Koss, Leopold G.; Flehinger, Betty J.; Kelisky, Richard P.; Dubrow, Hilliard

    1969-01-01

    Study of the prevalence rates of uterine cervical carcinoma in situ among women attending centres of Planned Parenthood of New York City, Inc., showed a small but statistically significant difference between the population choosing and using the diaphragm and the population choosing and using oral steroids for contraception. This can be attributed either to a decreased prevalence rate for women using the diaphragm or to an increased rate for women using oral steroids. The reason for the difference is not apparent from these data. PMID:5792609

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

    PubMed Central

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

    2014-01-01

    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

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

    PubMed Central

    2013-01-01

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

  5. Contraceptive prevalence and preference in a cohort of south–east Nigerian women

    PubMed Central

    Egede, John Okafor; Onoh, Robinson Chukwudi; Umeora, Odidika Ugochukwu Joannes; Iyoke, Chukwuemeka Anthony; Dimejesi, Ikechukwu Benedict Okechukwu; Lawani, Lucky Osaheni

    2015-01-01

    Background Rates of fertility, population growth, and maternal deaths in Nigeria are among the highest in the world, with an estimated 4% of all births being unwanted and 7% mistimed. These are caused mainly by nonuse, inappropriate choice, and difficulty in accessing contraceptive commodities. The purpose of this study was to determine the prevalence and factors influencing the choice and sources of contraceptive options among market women in Ebonyi State, Nigeria. Methods This was a questionnaire-based, cross-sectional, descriptive study involving 330 market women of reproductive age in Abakaliki, Ebonyi State, Nigeria. A survey was carried out to identify their knowledge, use, and sources of contraception and the factors that influence their contraceptive practices. Results Knowledge of contraception was high (275 [83.3%]), and 229 (69.4%) of the study population approved of contraceptive use. However, only 93 (28.3%) of the respondents were currently using any form of contraception. Fifty-four women (16.3%) were using modern methods. The commonly used forms of modern contraception were the barrier method (male condoms, 27 [8.2%]), the oral contraceptive pill (10 [3.0%]), injectables (8 [2.5%]), and the intrauterine contraceptive device (7 [2.0%]). The most common source of contraceptive products was patent medicine dealers (58 [51%]). The main barriers to use of contraception were desire for more children (86 [26.1%]), religious prohibition (62 [18.8%]), spousal disapproval (32 [9.7%]), and the perceived side effects of modern contraceptives (25 [7.6%]). There was a significant association for approval of contraception when the model was adjusted for religion (odds ratio [OR] 0.39, 95% confidence interval [CI] 0.18–0.84; P=0.02); educational status (OR 2.84, 95% CI 0.96–8.40; P=0.04); parity (OR 1.78, 95% CI 1.09–2.85; P=0.03); and social class (OR 2.54, 95% CI 1.26–5.11; P=0.01). Conclusion There is good knowledge about contraception among Nigerian women, but use of these products is low. The main barriers to use of contraception are the desire for more children, religious prohibition, and spousal disapproval. PMID:26045662

  6. Estimating Contraceptive Prevalence Using Logistics Data for Short-Acting Methods: Analysis Across 30 Countries

    PubMed Central

    Cunningham, Marc; Brown, Niquelle; Sacher, Suzy; Hatch, Benjamin; Inglis, Andrew; Aronovich, Dana

    2015-01-01

    Background: Contraceptive prevalence rate (CPR) is a vital indicator used by country governments, international donors, and other stakeholders for measuring progress in family planning programs against country targets and global initiatives as well as for estimating health outcomes. Because of the need for more frequent CPR estimates than population-based surveys currently provide, alternative approaches for estimating CPRs are being explored, including using contraceptive logistics data. Methods: Using data from the Demographic and Health Surveys (DHS) in 30 countries, population data from the United States Census Bureau International Database, and logistics data from the Procurement Planning and Monitoring Report (PPMR) and the Pipeline Monitoring and Procurement Planning System (PipeLine), we developed and evaluated 3 models to generate country-level, public-sector contraceptive prevalence estimates for injectable contraceptives, oral contraceptives, and male condoms. Models included: direct estimation through existing couple-years of protection (CYP) conversion factors, bivariate linear regression, and multivariate linear regression. Model evaluation consisted of comparing the referent DHS prevalence rates for each short-acting method with the model-generated prevalence rate using multiple metrics, including mean absolute error and proportion of countries where the modeled prevalence rate for each method was within 1, 2, or 5 percentage points of the DHS referent value. Results: For the methods studied, family planning use estimates from public-sector logistics data were correlated with those from the DHS, validating the quality and accuracy of current public-sector logistics data. Logistics data for oral and injectable contraceptives were significantly associated (P<.05) with the referent DHS values for both bivariate and multivariate models. For condoms, however, that association was only significant for the bivariate model. With the exception of the CYP-based model for condoms, models were able to estimate public-sector prevalence rates for each short-acting method to within 2 percentage points in at least 85% of countries. Conclusions: Public-sector contraceptive logistics data are strongly correlated with public-sector prevalence rates for short-acting methods, demonstrating the quality of current logistics data and their ability to provide relatively accurate prevalence estimates. The models provide a starting point for generating interim estimates of contraceptive use when timely survey data are unavailable. All models except the condoms CYP model performed well; the regression models were most accurate but the CYP model offers the simplest calculation method. Future work extending the research to other modern methods, relating subnational logistics data with prevalence rates, and tracking that relationship over time is needed. PMID:26374805

  7. Prevalence of Abortion and Contraceptive Practice among Women Seeking Repeat Induced Abortion in Western Nigeria

    PubMed Central

    Lamina, Mustafa Adelaja

    2015-01-01

    Background. Induced abortion contributes significantly to maternal mortality in developing countries yet women still seek repeat induced abortion in spite of availability of contraceptive services. The aim of this study is to determine the rate of abortion and contraceptive use among women seeking repeat induced abortion in Western Nigeria. Method. A prospective cross-sectional study utilizing self-administered questionnaires was administered to women seeking abortion in private hospitals/clinics in four geopolitical areas of Ogun State, Western Nigeria, from January 1 to December 31 2012. Data were analyzed using SPSS 17.0. Results. The age range for those seeking repeat induced abortion was 15 to 51 years while the median age was 25 years. Of 2934 women seeking an abortion, 23% reported having had one or more previous abortions. Of those who had had more than one abortion, the level of awareness of contraceptives was 91.7% while only 21.5% used a contraceptive at their first intercourse after the procedure; 78.5% of the pregnancies were associated with non-contraceptive use while 17.5% were associated with contraceptive failure. The major reason for non-contraceptive use was fear of side effects. Conclusion. The rate of women seeking repeat abortions is high in Nigeria. The rate of contraceptive use is low while contraceptive failure rate is high. PMID:26078881

  8. The World Fertility Survey and Contraceptive Prevalence Surveys: a comparison of substantive results.

    PubMed

    Anderson, J E; Cleland, J G

    1984-01-01

    This paper deals with the findings of the World Fertility Survey (WFS) and Contraceptive Prevalence Surveys (CPSs) in five areas of common interest: fertility, contraceptive use, measuring the effect of the availability of contraceptives on levels of use, the unmet need for family planning services, and breastfeeding. The comparisons have several implications for those designing surveys of fertility and family planning in developing countries, among them, that women should be asked for the dates of at least their last two births (not just the last birth as in the CPSs) in order to ensure accurate estimates of fertility and duration of breastfeeding. PMID:6701950

  9. Basal metabolic rate of women on the contraceptive pill.

    PubMed

    Curtis, V; Henry, C J; Ghusain-Choueiri, A

    1996-05-01

    The aim of this study was to investigate the variability in basal metabolic rate (BMR) of women taking the contraceptive pill through sequential measurement over the course of one menstrual cycle. A randomized study design was used, and the setting was the metabolic room at the School of Biological and Molecular Sciences, Oxford Brookes University, in the UK. BMR of 5 weight-stable women taking the contraceptive pill was measured 3-4 times each week for a period of 5 consecutive weeks. BMR was measured using a Douglas bag. The pattern of variation in BMR was random for individual subjects throughout the period of measurement. The level of intraindividual variation indicated by the coefficient of variation (CV) ranged from 2.4% to 4.87%. Women taking the contraceptive pill did not exhibit the cyclicity or variation in BMR observed in some normally ovulating subjects. BMR in women taking the contraceptive pill could therefore be considered a 'biological constant'. PMID:8735314

  10. Lifetime Prevalence of Sexual Intercourse and Contraception Use at Last Sex Among Adolescents and Young Adults With Congenital Heart Disease

    PubMed Central

    Fry, Kevin M.; Gerhardt, Cynthia A.; Ash, Jerry; Zaidi, Ali N.; Garg, Vidu; McBride, Kim L.; Fitzgerald-Butt, Sara M.

    2016-01-01

    Purpose Because of the increased risks associated with unplanned pregnancy for males and females with congenital heart disease (CHD), we investigated sexual intercourse and contraception use in these adolescents and young adults (AYA) and compared the same with national and state population data. Methods We recruited 337 AYA with structural CHD aged 15–25 years (Mage = 19 years, standard deviation = 3.1; 53% male, 84% white) from an outpatient cardiology clinic to participate in a larger study assessing genetic knowledge and health behaviors. Cumulative lifetime prevalence of adolescent (aged 15–18 years) sexual intercourse was compared with the 2011 Youth Risk Behavior Surveillance System and the 2007 Ohio Youth Risk Behavior Survey. Cumulative lifetime prevalence of young adult (aged 19–25 years) sexual intercourse and contraception use at last sex were compared with the 2006–2008 National Survey of Family Growth. Results Reported rates of ever having sexual intercourse, 26% of adolescents and 74% of young adults with CHD, were significantly lower than general population rates (47% and 86% respectively; p < .001). Similar to the general population, 77% of previously sexually active young adults with CHD reported using at least one effective method of contraception at last intercourse, whereas 25% used dual effective methods and 23% used no effective method. Conclusions Lower rates of ever having sexual intercourse in this population suggest that the psychosexual development of AYA with CHD may lag behind their peers. As nearly one in four participants reported using no effective method of contraception, health care providers should increase discussions of contraception with males and females with CHD. PMID:25797631

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

    PubMed Central

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

    2013-01-01

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

  12. Oral contraceptives decrease the prevalence of ovarian cancer in the hen.

    PubMed

    Treviño, Lindsey S; Buckles, Elizabeth L; Johnson, Patricia A

    2012-02-01

    Ovarian cancer is the leading cause of reproductive cancer death in U.S. women. This high mortality rate is due to the lack of early detection methods and ineffectiveness of therapy for advanced disease. Until more effective screening methods and therapies are developed, chemoprevention strategies are warranted. The hen has a high spontaneous prevalence of ovarian cancer and has been used as a model for studying ovarian cancer chemoprevention. In this study, we used the hen to determine the effect of progestin alone, estrogen alone, or progestin and estrogen in combination (as found in oral contraceptives) on ovarian cancer prevalence. We found that treatment with progestin alone and in combination with estrogen decreased the prevalence of ovarian cancer. A significant risk reduction of 91% was observed in the group treated with progestin alone (risk ratio = 0.0909; 95% CI: 0.0117-0.704) and an 81% reduction was observed in the group treated with progestin plus estrogen (risk ratio = 0.1916; 95% CI = 0.043-0.864). Egg production was also significantly reduced in these treatment groups compared with control. We found no effect of progestin, either alone or in combination with estrogen, on apoptosis or proliferation in the ovary, indicating that this is not the likely mechanism responsible for the protective effect of progestin in the hen. Our results support the use of oral contraceptives to prevent ovarian cancer and suggest that ovulation is related to the risk of ovarian cancer in hens and that other factors, such as hormones, more than likely modify this risk. PMID:22135044

  13. Rheumatoid factor (antigammaglobulin) in women: effects of oral contraceptives use of its prevalence.

    PubMed

    Sponzilli, E E; Ramcharan, S; Wingerd, J

    1976-01-01

    A total of 14,856 women, including 921 pregnant subjects, were tested for rheumatoid factor; 4,562 were using oral contraceptives at the time of testing. The prevalence of rheumatoid factor increased directly with age. The age-adjusted prevalence of rheumatoid factor was lower in oral contraceptive users than in nonusers but this difference was not statistically significant. Rheumatoid factor remained positive in 39% of subjects undergoing retesting after an average interval of 16 months. Those women with higher titers of rheumatoid factor were more likely to remain positive (81%). Of the women having positive tests, 5.4% were identified as having rheumatoid disease. PMID:59601

  14. Estimating family planning coverage from contraceptive prevalence using national household surveys

    PubMed Central

    Barros, Aluisio J. D.; Boerma, Ties; Hosseinpoor, Ahmad R.; Restrepo-Méndez, María C.; Wong, Kerry L. M.; Victora, Cesar G.

    2015-01-01

    Background Contraception is one of the most important health interventions currently available and yet, many women and couples still do not have reliable access to modern contraceptives. The best indicator for monitoring family planning is the proportion of women using contraception among those who need it. This indicator is frequently called demand for family planning satisfied and we argue that it should be called family planning coverage (FPC). This indicator is complex to calculate and requires a considerable number of questions to be included in a household survey. Objectives We propose a model that can predict FPC from a much simpler indicator – contraceptive use prevalence – for situations where it cannot be derived directly. Design Using 197 Multiple Indicator Cluster Surveys and Demographic and Health Surveys from 82 countries, we explored least-squares regression models that could be used to predict FPC. Non-linearity was expected in this situation and we used a fractional polynomial approach to find the best fitting model. We also explored the effect of calendar time and of wealth on the models explored. Results Given the high correlation between the variables involved in FPC, we managed to derive a relatively simple model that depends only on contraceptive use prevalence but explains 95% of the variability of the outcome, with high precision for the estimated regression line. We also show that the relationship between the two variables has not changed with time. A concordance analysis showed agreement between observed and fitted results within a range of ±9 percentage points. Conclusions We show that it is possible to obtain fairly good estimates of FPC using only contraceptive prevalence as a predictor, a strategy that is useful in situations where it is not possible to estimate FPC directly. PMID:26562141

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

    PubMed

    Strifert, Kim

    2014-12-01

    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 11 million 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

  16. Contraceptive failure rates based on the 1988 NSFG.

    PubMed

    Jones, E F; Forrest, J D

    1992-01-01

    Analysis of data from the 1988 National Survey of Family Growth--corrected for the underreporting of abortion--reveals that contraceptive failure during the first year of use remains a serious problem in the United States, contributing substantially to unintended pregnancy. The pill continues to be the most effective reversible method for which data were available (8% of users accidentally became pregnant during the first year of use), followed by the condom (15%). Periodic abstinence is the method most likely to fail (26%), but accidental pregnancy is also relatively common among women using spermicides (25%). Failure rates vary more by user characteristics such as age, marital status and poverty status than by method, suggesting the extent to which failure results from improper and irregular use rather than from the inherent limitations of the method. PMID:1601121

  17. Sporadic Contraceptive Use and Non-Use: Age-Specific Prevalence and Associated Factors

    PubMed Central

    PAZOL, Karen; WHITEMAN, Maura K.; FOLGER, Suzanne G.; KOURTIS, Athena P.; MARCHBANKS, Polly A.; JAMIESON, Denise J.

    2015-01-01

    OBJECTIVE To characterize age-group specific patterns in the stability of contraceptive use, and evaluate whether factors associated with non-use and sporadic use as compared to stable use differ by age among women at risk for unintended pregnancy. STUDY DESIGN We used data from the 2006–2010 National Survey of Family Growth to characterize the prevalence of stable and sporadic contraceptive use and non-use by age over a 1-year period. We used polytomous logistic regression models to assess the odds of contraceptive non-use and sporadic use versus stable use. Age-stratified models were used to show age-group differences in associated characteristics. RESULTS Over a 1-year period, stable contraceptive use decreased across age groups from 80% for teens 15–19 years to 74% for women 20–24 years, and 70–71% for women 25–34 and 35–44 years. Contraceptive non-use increased across age groups from 5% for teens 15–19 years to 9%–20% for older women. By contrast sporadic use was least common for women 35–44 years (10%, compared to 16–17% for younger women). Among teens 15–19 years, a history of method discontinuation due to dissatisfaction was associated with non-use. Among older women, intentions to have children in the future and reported difficulty achieving pregnancy were associated with non-use and sporadic use. CONCLUSION Because the stability of contraceptive use and associated factors differ by age, providers may need to consider these differences when talking to women about contraception. To address non-use, it may be especially important to help teens identify a method they are comfortable using, while for older women it may be more important to discuss the potential for continuing fertility. To address sporadic use, it may be helpful to discuss the benefits of user-independent methods, with a particular emphasis on long acting reversible contraceptives for younger women and teens who are less likely to have completed their desired childbearing and have tended to rely on methods that are more difficult to use consistently. PMID:25305406

  18. Does counselling improve uptake of long-term and permanent contraceptive methods in a high HIV-prevalence setting?

    PubMed Central

    Dudley, Lilian; Makumucha, Courage; Dlamini, Phatisizwe; Moyo, Sihle; Bhembe, Sibongiseni

    2015-01-01

    Abstract Background Studies have shown a reduced uptake of contraceptive methods in HIV-positive women of childbearing age, mainly because of unmet needs that may be a result of poor promotion of available methods of contraception, especially long-term and permanent methods (LTPM). Aim To compare the uptake of contraceptive methods, and particularly LTPM, by HIV-positive and HIV-negative post-partum mothers, and to assess the effects of counselling on contraceptive choices. Setting Three government district hospitals in Swaziland. Methods Interviews were conducted using a structured questionnaire, before and after counselling HIV-negative and HIV-positive post-partum women in LTPM use, unintended pregnancy rates, future fertility and reasons for contraceptive choices. Results A total of 711 women, of whom half were HIV-positive, participated in the study. Most (72.3% HIV-negative and 84% HIV-positive) were on modern methods of contraception, with the majority using 2-monthly and 3-monthly injectables. Intended use of any contraceptive increased to 99% after counselling. LTPM use was 7.0% in HIV-negative mothers and 15.3% in HIV-positive mothers before counselling, compared with 41.3% and 42.4% in HIV-negative and HIV-positive mothers, respectively, after counselling. Pregnancy intentions and counselling on future fertility were significantly associated with current use of contraception, whilst current LTPM use and level of education were significantly associated with LTPM post-counselling. Conclusion Counselling on all methods including LTPM reduced unmet needs in contraception in HIV-positive and HIV-negative mothers and could improve contraceptive uptake and reduce unintended pregnancies. Health workers do not always remember to include LTPM when they counsel clients, which could result in a low uptake of these methods. Further experimental studies should be conducted to validate these results. PMID:26842525

  19. Contraceptive failure rates: new estimates from the 1995 National Survey of Family Growth.

    PubMed

    Fu, H; Darroch, J E; Haas, T; Ranjit, N

    1999-01-01

    This study estimated method-specific contraceptive failure rates in the US. Estimates were adjusted for underreporting of induced abortion in the main survey. The correction made a sizeable impact, as 25% of the 2,157,473 conceptions due to contraceptive failure were aborted. Data were obtained from the 1995 National Survey of Family Growth and the 1994-95 Abortion Patient Survey. Analysis was based on hazard models for failure in the first 6 and 12 months. Data include 7276 contraceptive use segments. The mean duration was 9.6 months. The pill and condom had the largest shares of use segments. The lowest failure rates were for implants and injectables (2-3%). Failure rates were as follows: oral pills (8%), diaphragm and cervical cap (12%), male condom (14%), periodic abstinence (21%), withdrawal (24%), and spermicides (26%). Failure rates were highest among cohabiting and other unmarried women; women with an annual family income below 200% of the federal poverty level; among Black and Hispanic women; and among adolescents and women in their 20s. The failure rate among low income women declined during 1988-95. Women above the 200% of poverty level had stable rates. Poverty continued to have a negative impact on effective contraceptive use. Four models were used to examine the effects of socioeconomic factors on contraceptive failure. PMID:10224543

  20. Prevalence and Factors Associated with Sexually Transmitted Infections among HIV Positive Women Opting for Intrauterine Contraception

    PubMed Central

    2015-01-01

    Background Women living with HIV/AIDS (WLHA) are a high risk group for sexually transmitted infections (STIs). However, the majority of women with STIs are asymptomatic. Data on prevalence of STIs among WLHA in Uganda are limited. The objective of the study was to determine prevalence and factors associated with STIs among WLHA opting for intrauterine contraceptive device (IUD). Methods Three hundred fifty one WLHA deemed free of STIs using a syndromic logarithm were enrolled into the study. Endo-cervical swabs were taken before IUD insertion and PCR test for Nisseria gonorrhea (NG), Trichomonas vaginalis (TV) and Chlamydia trachomatis (CT) infections conducted. Results Participants mean age was 29.4 6.2 years, 83% were under 35years, 50% had secondary education and 73% were married. The majority (69%) had disclosed their HIV sero status to their spouses, 82% used Cotrimoxazole prophylaxis, 70% were on antiretroviral therapy, 90% had CD4 count greater than 350, about 60% reported condoms use and 70% were of parity 2-4. Over 50% of the participants spouses were older than 35 years and 72% had attained secondary education. STIs prevalence was 11.1%, (95% CI 7.8-14.4) and individual prevalence for TV, NG, and CT was 5.9%, 5.4% and 0.9% respectively. Factors independently associated with STI were having primary or less education (OR= 2.3, 95% CI: 1.09 - 4.85) having a spouse of primary or less education (OR= 3.3, 95% CI: 1.6 - 6.78) and muslim faith (OR= 0.2, 95% CI: 0.04 - 0.78). Conclusion STI prevalence was 11.1%. TV and NG were the commonest STIs in this population. Having primary or less education for both participant and spouse was associated with increased risk while being of muslim faith was associated with reduced risk of STI. PMID:25859659

  1. Abortion rate expected to soar -- contraceptives, not ban the answer.

    PubMed

    1996-08-30

    Restrictions on women's right to safe, legal abortion threaten to increase maternal mortality even as the desire to limit family size is strengthened. About 2 out of every 5 abortions performed in the world are illegal, resulting in 50,000-100,000 preventable maternal deaths each year. In India, abortion has been legal since 1969; however, a lack of access to affordable health services leads 4-5 million Indian women each year to seek clandestine abortions, with 15,000-25,000 related deaths. In countries where doctors are in short supply, abortion-related mortality could be significantly reduced if community health care providers were trained in first-trimester manual vacuum aspiration. Although contraception can dramatically reduce the need for abortion, it will never eliminate it. No country has been able to achieve low fertility without recourse to abortion. PMID:12179203

  2. Contraception by the end of the 20th century.

    PubMed

    Spira, A

    1994-03-01

    Despite worldwide fertility declines, global population continues to grow. Most of the decline in fertility is due to contraceptive use, accounting for 80% of the variance in the total fertility rate between countries. Yet, some countries have much higher or lower fertility levels than countries with the same contraceptive prevalence levels, indicating that other factors also influence fertility rates. These factors are generally cultural. Africa is the only area where contraceptive prevalence is still low in most countries (e.g., 13% for Sub-Saharan Africa vs. 57% for Latin America). Use of individual contraceptive methods varies from country to country. For example, most contraceptive users in Japan use the condom, while those in India depend on female sterilization (about 75% and 75%, respectively). Between the late 1970s and the late 1980s, contraceptive prevalence increased 1 percentage point annually in 64% of all countries. In those developing countries where contraceptive prevalence rates have approached those of developed countries (e.g., Columbia and Thailand), the growth in contraceptive use is slowing. Important determinants of contraceptive use include rural/urban residence, education level, and income per capita. The difference in use rates between rural and urban areas are largely due to availability of family planning services in urban areas. Since contraceptive use plays such a significant role in fertility reduction and the slowing of population growth, improved contraception is needed worldwide, regardless of socioeconomic class. Desires of the population and not those of the scientists should be considered when developing new contraceptives. An analysis of users' needs should be done before developing new contraceptives. Such an analysis would require social and behavioral research. The approach of listening to the needs and beliefs of users should result in an increase of contraceptive use, which will benefit everyone. PMID:8006132

  3. Estimates of unintended pregnancy rates over the last decade in France as a function of contraceptive behaviors

    PubMed Central

    Moreau, C.; Bohet, A.; Trussell, J.; Bajos, N.

    2013-01-01

    Objective We investigate trends in contraceptive behaviors in France and how they may have contributed to fluctuations in unintended pregnancy rates over time and across subgroups of the population between 2000 and 2010. Study design Data are drawn from 3 national surveys in France, comprising 4714 women ages 15 to 49 in 2000, 8613 in 2005 and 5260 in 2010. We used multinomial and simple logistic regression models to explore trends in contraceptive behaviors over time. We estimated trends in unintended pregnancy rates in relation to population shifts in contraceptive behaviors between 2000 and 2010. Results A third of women were not using contraception at the time of the surveys. However, only 2.4% in 2000, 3.2% in 2005 and 2.4% in 2010 had an unmet need for contraception (p=0.002). Among contraceptive users, user-dependent hormonal methods decreased from 59% in 2000 to 52% in 2010 (p<0.0001), while long acting reversible methods increased from 22% to 24% (p=0.04). Changes in contraceptive behaviors resulted in fluctuations in unintended pregnancy rates estimated to have risen from 3.16% to 3.49% between 2000 and 2005, and to have decreased to 3.26% in 2010. Small changes in unmet need for contraception exerted the largest effects. Conclusion This study indicates that changes in contraceptive behaviors over the past decade in France have potentially resulted in significant fluctuations in unintended pregnancy rates. Our results also demonstrate that a simple algorithm combining contraceptive behaviors and typical use failure rates may be an acceptable proxy for monitoring trends in unintended pregnancies. PMID:24560475

  4. Continuation rates of the subdermal contraceptive Implanon(®) and associated influencing factors.

    PubMed

    Teunissen, Anna Maria; Grimm, Bernd; Roumen, Frans J M E

    2014-02-01

    OBJECTIVES To investigate the continuation rates of the etonogestrel subdermal contraceptive implant among well-informed women, and the reasons for early discontinuation. STUDY DESIGN Retrospective consecutive cohort design. METHODS Women who had the implant inserted between 1 January 2006 and 1 January 2010 at the Atrium Medical Centre, the Netherlands were followed up for at least three years. The dates of insertion and removal were recorded, as were the reasons for removal. Statistical analysis was performed using the independent samples t-test and the Pearson alpha correlation test. RESULTS The implant was inserted in 230 women. Follow-up was possible in 214 women, with an average age of 26.7 years. Most of them were nulliparous and the majority had used a combined oral contraceptive, Implanon®, or Mirena® previously. The mean overall continuation period was 23.5 months (95% confidence interval: 21.7-25.3), with a median of 25 months. The continuation rate after 12 months was 72%; after 24 months, 53%; and after 36 months, 25%, with all women concerned having a new implant placed. The previously used contraceptive method Implanon® was associated with the highest continuation rates. An erratic bleeding pattern was the main reason for early removal. CONCLUSIONS Despite adequate counselling before insertion, the continuation rate of the etonogestrel implant was rather low compared to those reported by other investigators. The main reason for discontinuation was an irregular bleeding pattern. PMID:24329119

  5. Use of Contraception and Attitudes towards Contraceptive Use in Swedish Women - A Nationwide Survey

    PubMed Central

    Kopp Kallner, Helena; Thunell, Louise; Brynhildsen, Jan; Lindeberg, Mia; Gemzell Danielsson, Kristina

    2015-01-01

    Objective To describe contraceptive use and attitudes towards contraceptive use in Sweden which has the highest abortion rate in Western Europe. Secondary objectives were to investigate knowledge of contraceptive methods and outcomes of unplanned and unwanted pregnancies. Design Telephone survey. Setting National survey of women living in Sweden. Population Women between 16 and 49 years. Methods The survey contained 22 questions with free text and multi choice answers on demographics, contraceptive use, knowledge of and attitudes towards contraception, the importance of monthly bleeding and experience of unintended pregnancy. Main Outcome Measures Distribution of use of contraceptive methods and non-use of contraception among Swedish women. Prevalence and outcome of unintended pregnancies. Results A total of 1001 women participated in the survey. Of all women, 721/1001 (72.1%) currently used contraception whereas 268/1001 (26.8%) women did not. Long acting reversible contraception, (LARC; implant and intra uterine contraception) was used by 24.3% of women. The unmet need of contraception in Sweden was estimated at 8.9% (89/1001 women). A total of 781 (78%) women had never experienced an unintended pregnancy whereas 220 (22%) women had had at least one unintended pregnancy. Users and non-users alike stated that one of the most important characteristics of a contraceptive method is its effectiveness. Conclusions Sweden has a large unmet need for contraception. Furthermore, a large proportion of women have experienced at least one unintended pregnancy. Increasing contraceptive use and promotion of LARC is a possible way forward in the effort to reduce the rates of unwanted pregnancies. PMID:25992901

  6. Providing Contraception to Adolescents.

    PubMed

    Raidoo, Shandhini; Kaneshiro, Bliss

    2015-12-01

    Adolescents have high rates of unintended pregnancy and face unique reproductive health challenges. Providing confidential contraceptive services to adolescents is important in reducing the rate of unintended pregnancy. Long-acting contraception such as the intrauterine device and contraceptive implant are recommended as first-line contraceptives for adolescents because they are highly effective with few side effects. The use of barrier methods to prevent sexually transmitted infections should be encouraged. Adolescents have limited knowledge of reproductive health and contraceptive options, and their sources of information are often unreliable. Access to contraception is available through a variety of resources that continue to expand. PMID:26598305

  7. Contraceptive use among young women in Estonia: Association with contraceptive services.

    PubMed

    Part, Kai; Ringmets, Inge; Laanpere, Made; Rahu, Mati; Karro, Helle

    2016-04-01

    Objectives Our study aimed to explore the association between the use of effective contraceptive methods and access to different contraceptive services, as well as to describe accessibility-related obstacles when using contraceptive services and satisfaction with those services. Methods From a population-based cross-sectional study carried out in 2004 (response rate 53.8%), the data of 16- to 24-year-old women requiring contraception (N = 868) were analysed. Factors associated with the use of effective contraceptive methods and, specifically, hormonal methods, were explored using multiple logistic regression analysis. Results Effective contraception was used by 75.1% of the respondents. The use of effective contraceptive methods was associated with school-based sexuality education (adjusted prevalence odds ratio 2.69; 95% confidence interval 1.32 - 5.50), visiting a youth-friendly clinic (YFC) (1.82; 1.03-3.23) or a private gynaecologist (2.08; 1.11-3.92). The use of hormonal methods was additionally associated with being a native Estonian speaker and visiting a family doctor. More than half of the respondents reported some obstacle in accessing contraceptive services. The highest satisfaction ratings were given to YFCs. Conclusions Steps to promote the use of services that are youth-friendly and associated with better uptake of effective contraceptive methods are needed among all 16- to 24-year-old women. PMID:26098563

  8. Continuation Rates and Complications of Intrauterine Contraception in Women Diagnosed With Bipolar Disorder

    PubMed Central

    Berenson, Abbey B.; Asem, Humera; Tan, Alai; Wilkinson, Gregg S.

    2011-01-01

    Objective To estimate continuation rates, complications, and psychiatric hospitalizations among women with bipolar disorder using levonorgestrel-releasing or copper-containing (CuT380A) intrauterine devices (IUD), as compared with those using depot medroxyprogesterone acetate (DMPA) or sterilization for birth control. Methods Data for this cohort study were obtained from a nationwide health insurance claims database on an employed, commercially insured population. Women aged 1844 with a prior diagnosis of bipolar disorder (n = 849), who were using the levonorgestrel intrauterine system, CuT380A, DMPA, or sterilization were evaluated. Outcomes included continuation rates over a 12-month interval, infectious and noninfectious complications, and hospitalizations for bipolar disorder or depression. Results Women using an IUD were more likely than those using DMPA to continue the method for at least 12 months (CuT380A, 86%; levonorgestrel intrauterine system, 87%). In comparison, only 31% of those who initiated DMPA received three more injections during the following year (p<0.0001). No significant differences were noted in infectious or noninfectious complications by contraceptive type. Finally, no differences were observed in the number of hospitalizations for bipolar disorder or depression among the four contraceptive groups. Conclusions More women with bipolar disorder continued using IUDs at one year than women using DMPA. The rates of complications and psychiatric hospitalizations were not different among women using an IUD, DMPA, or sterilization. PMID:22105263

  9. Implantable contraception.

    PubMed

    Bardin, C W

    1994-01-01

    Research on contraceptive implants began when it was learned that steroids could be released from Silastic rubber capsules. The six-capsule Silastic drug delivery system, which would eventually be called Norplant, was by 1974 perfected and prepared for clinical trials. By 1978, data had accumulated to indicate a failure rate for Norplant after two years of only 0.6%, so Leiras Pharmaceuticals of Turku, Finland, was licensed in 1983 to manufacture Norplant, and Finland became the first country to give regulatory approval for distribution of the new contraceptive. The World Health Organization, after a 1984 evaluation, concluded that the Norplant system is an effective, reversible, long-term method of fertility regulation which is particularly appropriate for women in need of long-term contraceptive protection. Wyeth-Ayerst Laboratories began to distribute the device in the US after it met US Food and Drug Administration approval. 24 countries have now approved Norplant for distribution and use among women. This paper describes the Norplant contraceptive system, its mechanism of action, insertion and removal, effectiveness, contraindications, and adverse effects with regard to menstrual problems, medical problems, infection or pain, drug interactions, ectopic pregnancy, foreign body carcinogenesis, and other adverse reactions. It also notes use benefits in terms of contraceptive action, convenience, the reduction of adverse reactions for former oral contraception users, and the prevention of anemia, and lists categories of potential acceptors and women who may not wish to use Norplant. PMID:7704729

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

    PubMed

    McGowan, James G

    2013-09-01

    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

  11. [Contraception in immigrant women: influence of sociocultural aspects on the choice of contraceptive method].

    PubMed

    Paraíso Torras, B; Maldonado Del Valle, M D; López Muñoz, A; Cañete Palomo, M L

    2013-01-01

    There are currently 6 million immigrants living in Spain. Half of them are women, the majority of whom are of childbearing age. These women, who suffer high rates of induced abortion, form a special group who require a special approach to their reproductive health. In order to study the use of contraceptive methods in this population, a review was made of 1100 clinical histories from our Sexual Health and Reproduction Clinic. Latin American women were the most prevalent group who came to seek information about contraception, followed by Eastern Europeans and Moroccans. Fewer Asian and Sub-Saharan women sought these services. The contraceptives most frequently used were the intrauterine device (used mostly by Latin American and Eastern European women), and combined oral contraception, most used by Moroccan women. It is important to advise the immigrant women about contraceptive methods, taking into account their preferences, in order to improve adherence to the method. PMID:23583187

  12. Plan A: postabortion contraception.

    PubMed

    Micks, Elizabeth; Prager, Sarah

    2014-12-01

    More than 1 million abortions are performed annually in the United States. Women presenting for abortion care are often motivated by the pregnancy to use effective contraception; they are also at high risk for repeat unintended pregnancy. For these reasons, abortion represents an optimal time to initiate effective contraception. There is strong evidence that most methods of contraception, including intrauterine devices and the contraceptive implant, should be initiated at the time of the abortion procedure. Most women ovulate within the first month after an abortion. If provision of contraception is delayed, women are less likely to use effective contraception and more likely to have a repeat unintended pregnancy. Although some methods of permanent contraception can be safely performed at the time of abortion, federal and state laws often restrict these procedures being performed concurrently. Contraceptive counseling and provision at the time of abortion are important strategies to decrease rates of unintended pregnancy. PMID:25254920

  13. Contraception for adolescents.

    PubMed

    2014-10-01

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

  14. Heart rate variability across the menstrual cycle in young women taking oral contraceptives.

    PubMed

    Teixeira, Andr L; Ramos, Plnio S; Vianna, Lauro C; Ricardo, Djalma R

    2015-11-01

    Previous studies have shown that resting heart rate variability (HRV) is modified by different phases of the menstrual cycle in nonusers of oral contraceptive pills (OCP); however, the effect of OCP on autonomic control of the heart remains unclear. The purpose of this study was to investigate HRV during the low hormone (LH-not taking OCP) and during the high hormone (HH-active OCP use) phases of the menstrual cycle in young women. Seventeen healthy women (19-31 years) taking OCP for at least 6 consecutive months were enrolled in this study. Plasma estradiol and progesterone were verified at each visit. HRV was assessed by using one-lead electrocardiography in time and frequency domains, in which participants rested in the supine position for a 20-min period with a breathing rate of 15 cycles/min. In addition, resting heart rate, and systolic and diastolic blood pressure were obtained. Both plasma estradiol (LH: 19.8??4.2 pg/mL vs. HH: 12.4??1.5 pg/mL; p?>?.05) and progesterone (LH: 0.247??0.58 ng/mL vs. HH: 0.371??0.08 ng/mL; p?>?.05) (mean??SE) levels were similar in both phases. No significant difference was obtained for any component of HRV, heart rate, or blood pressure between the LH and HH phases (p?>?.05). These results provide preliminary evidence that use of OCP does not affect HRV during the menstrual cycle in healthy women. PMID:26332575

  15. [Social marketers' lack of success in using CSM discipline to harness commercial resources and increase contraceptive prevalence].

    PubMed

    Davies, J

    1984-01-01

    Social marketers have certainly shown that the CSM discipline can quickly and cost-effectively harness commercial resources to increase contraceptive prevalence. But why hasn't the social marketing idea caught on in more countries? According to Social Marketing Forum, only a tiny number of countries have active programs after more than a decade of effort. The most likely reason for this lack of success is doubt and fear on the part of both developing countries' officials and donor agencies about allowing marketing enthusiasts--with our very noticeable advertising methods--to join the family planning fight. And what has our answer been? Usually, a head-on retort such as, "But look at all the condoms we've sold]" And that gets us nowhere, because the successful peddling of 1 not-so-impressive method doesn't begin to balance the fears of a possible backlash that brash condom promotions could bring down on official heads. The lesson we should be learning is that social marketers possess to narrow an outlook and promote a small range of products that don't enthuse decisionmakers. Hence, we are often perceived as condom salesmen--and not much more. What should we be doing? We should be selling the idea of using private sector experience to assist national development. That means social development, particularly improved health, family planning and women's education. These 3 activities have proven effective in reducing fertility and would add up to a marketing opportunity--a longterm challenge that should enthuse dicisionmakers, private sector entrepreneurs and donor agencies alike. Further, our model--the commercial sector--is renowned for branching out and secceeding in a broad range of endeavors. As an example, Procter and Gamble uses separate divisions to market different products. Initiatives already exist in many countries to harness the private sector as a development tool. Social marketers should be leading the initiative--and benefitting from it, too. PMID:12266330

  16. [Contraception and adolescence].

    PubMed

    Amate, P; Luton, D; Davitian, C

    2013-06-01

    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

  17. Body composition and resting metabolic rate of perimenopausal women using continuous progestogen contraception.

    PubMed

    Napolitano, Antonella; Zanin, Renata; Palma, Federica; Romani, Cecilia; Grandi, Giovanni; Di Carlo, Costantino; Cagnacci, Angelo

    2016-04-01

    Objective The effect on body composition and in particular on fat mass (FM) of 12 months' use of a desogestrel (DSG)-only contraceptive pill or the levonorgestrel-releasing intrauterine system (LNG-IUS) was evaluated in women in the perimenopause. Methods An observational study comprised 102 perimenopausal women: 42 received a 75 μg DSG pill, 34 received the 52 mg LNG-IUS, and 26 received no treatment. Body composition, body weight and resting metabolic rate (RMR) were evaluated at baseline and again after 12 months. Results FM did not change in the control group (- 0.5 ± 1.6%) but significantly increased in the LNG-IUS group (+ 1.1 ± 2.9%; p = 0.02 vs. controls) and in the DSG group (+ 2.8 ± 3.5%; p = 0.0001 vs. controls; p = 0.02 vs. LNG-IUS). Women treated with DSG or the LNG-IUS showed a non-significant increase in body weight, body mass index and waist circumference. RMR did not significantly vary in the control group (- 3.8 ± 292.9 kJ/ 24 h) and tended to decrease but not significantly in the LNG-IUS (115.5 ± 531.8 kJ/ 24 h) and DSG groups (305.9 ± 556.9 kJ/24 h). Conclusions The results of this preliminary study seem to indicate that in perimenopausal women continuous use of the DSG-only pill and to a lesser extent the LNG-IUS may favour FM accumulation. PMID:26305596

  18. [Contraception and obesity].

    PubMed

    Lobert, M; Pigeyre, M; Gronier, H; Catteau-Jonard, S; Robin, G

    2015-11-01

    The prevalence of obesity is increasing massively over several decades in industrialized countries. Obese women are sexually active but they use fewer contraceptive methods and are at high risk of unintended pregnancy. In addition, obesity is an important risk factor for venous thromboembolism events and arterial thrombosis (myocardial infarction and ischemic stroke). All of these data are to be considered in choosing a contraceptive method for obese women. Except depot medroxyprogesterone acetate injection, the progestin-only contraceptives (progestin only pills and etonogestrel subdermal implant) and the intra-uterine devices are the preferred contraceptive methods in obese women. The combined estrogen-progestin contraceptives (pill, patch and vaginal ring) may be proposed in very strict conditions (no other associated vascular risk factor). Obesity does not increase the risk of failure of most contraceptive methods. Bariatric surgery is a complex situation. It requires to program a possible pregnancy and contraception is needed for several months. Some bariatric surgical techniques such as by-pass can induce gastrointestinal malabsorption. In this situation, all oral contraceptives are not recommended because of a higher risk of failure. PMID:26527416

  19. Continuation rates of oral hormonal contraceptives in a cohort of first-time users: a population-based registry study, Sweden 20052010

    PubMed Central

    Josefsson, Ann; Wirhn, Ann-Britt; Lindberg, Malou; Foldemo, Anniqa; Brynhildsen, Jan

    2013-01-01

    Objective To investigate if continuation rates in first-time users of oral hormonal contraceptives differed between different formulations and to measure if the rates were related to the prescribing categories, that is, physicians and midwives. Design A longitudinal national population-based registry study. Setting The Swedish prescribed drug register. Participants All women born between 1977 and 1994 defined as first-time users of hormonal contraceptives from 2007 to 2009 (n=226?211). Main outcome measures A tendency to switch the type of hormonal contraceptive within 6?months use and repeated dispensation identical to the first were estimated as percentages and relative risks (RRs). Physicians and midwives prescription patterns concerning the women's continuation rates of oral hormonal contraceptive type. Results In Sweden, there were 782?375 women born between 1977 and 1994 at the time of the study. Of these, 226?211 women were identified as first-time users of hormonal contraceptives. Ethinylestradiol+levonorgestrel, desogestrel-only and ethinylestradiol+drospirenone were the hormonal contraceptives most commonly dispensed to first-time users at rates of 43.3%, 24.4% and 11.1%, respectively. The overall rate of switching contraceptive types in the first 6?months was 11.3%, which was highest for desogestrel-only (14.3%) and lowest for ethinylestradiol+drospirenone (6.6%). The switching rate for all three products was highest in the 16-year to 19-year age group. Having a repeated dispensation identical to the initial dispensation was highest for users of ethinylestradiol either combined with levonorgestrel or drospirenone, 81.4% and 81.2%, respectively, whereas this rate for the initial desogestrel-only users was 71.5%. The RR of switching of contraceptive type within the first 6?months was 1.35 (95% CI 1.32 to 1.39) for desogestrel-only and 0.63 (0.59 to 0.66) for ethinylestradiol+drospirenone compared with ethinylestradiol+levonorgestrel as the reference category. There were no differences in the women's continuation rates depending on the prescriber categories. Conclusions Desogestrel-only users conferred the highest switcher rate to another hormonal contraceptive within a 6-month period. Users of ethinylestradiol+levonorgestrel were more prone to switch to another product within 6?months than women using ethinylestradiol+drospirenone. These findings may be of clinical importance when tailoring hormonal contraceptives on an individual basis. PMID:24141970

  20. Effects of putative male pheromones on female ratings of male attractiveness: influence of oral contraceptives and the menstrual cycle.

    PubMed

    Thorne, Frances; Neave, Nick; Scholey, Andrew; Moss, Mark; Fink, Bernhard

    2002-08-01

    Previous research has revealed that natural and synthetic pheromones can enhance ratings of opposite sex attractiveness. The present study investigated the effects of exposure to male axillary secretions on female ratings of the sexual attractiveness of male stimuli. Thirty-two female undergraduates, half of whom were contraceptive pill users, rated male vignette characters and photographs of male faces on aspects of attractiveness. On two separate study days, corresponding to different phases of their menstrual cycle, stimuli were presented while exposed to male axillary pheromones and under a control condition (no pheromone). The order of testing was balanced with respect to pheromone/control condition and menstrual cycle phase. Pheromone exposure resulted in significantly higher attractiveness ratings of vignette characters and faces. Use of the contraceptive pill or menstrual cycle phase had equivocal effects on some vignette items and neither had any influence on female ratings of male facial attractiveness. The results of this study suggest that exposure to natural male axillary pheromones can significantly enhance female perceptions of various aspects of male attractiveness. PMID:12195229

  1. Emergency contraception

    MedlinePlus

    Morning-after pill; Postcoital contraception; Birth control - emergency; Plan B ... Mosby; 2012:chap 92. Jensen JT, Mishell DR. Family planning: contraception, sterilization, and pregnancy termination. In: Lentz GM, ...

  2. Falling fertility and increase in use of contraception in Zimbabwe.

    PubMed

    Mturi, Akim; Joshua, Kembo

    2011-06-01

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

  3. Unintended Pregnancy and Contraception Among Active Duty Servicewomen and Veterans

    PubMed Central

    Goyal, Vinita; Borrero, Sonya; Schwarz, Eleanor Bimla

    2012-01-01

    The number of women of childbearing age who are active duty service members or veterans of the U.S. military is increasing. These women may seek reproductive health care at medical facilities operated by the military, in the civilian sector or through the Department of Veterans Affairs. This article reviews the current data on unintended pregnancy and prevalence of and barriers to contraceptive use among active duty and veteran women. Active duty servicewomen have high rates of unintended pregnancy and low contraceptive use which may be due to official prohibition of sexual activity in the military, logistic difficulties faced by deployed women and limited patient and provider knowledge of available contraceptives. In comparison, little is known about rates of unintended pregnancy and contraceptive use among women veterans. Based on this review, research recommendations to address these issues are provided. PMID:22200252

  4. Contraceptive Development.

    ERIC Educational Resources Information Center

    Troen, Philip; And Others

    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…

  5. Postpartum contraception.

    PubMed

    Sober, Stephanie; Schreiber, Courtney A

    2014-12-01

    As birth spacing has demonstrated health benefits for a woman and her children, contraception after childbirth is recognized as an important health issue. The potential risk of pregnancy soon after delivery underscores the importance of initiating postpartum contraception in a timely manner. The contraceptive method initiated in the postpartum period depends upon a number of factors including medical history, anatomic and hormonal factors, patient preference, and whether or not the woman is breastfeeding. When electing a contraceptive method, informed choice is paramount. The availability of long-acting reversible contraceptive methods immediately postpartum provides a strategy to achieve reductions in unintended pregnancy. PMID:25264698

  6. State Variations in Womens Socioeconomic Status and Use of Modern Contraceptives in Nigeria

    PubMed Central

    Lamidi, Esther O.

    2015-01-01

    Background According to the 2014 World Population Data Sheet, Nigeria has one of the highest fertility and lowest contraceptive prevalence rates around the world. However, research suggests that national contraceptive prevalence rate overshadows enormous spatial variations in reproductive behavior in the country. Objective I examined the variations in womens socioeconomic status and modern contraceptive use across states in Nigeria. Methods Using the 2013 Nigeria Demographic and Health Survey data (n = 18,910), I estimated the odds of modern contraceptive use among sexually active married and cohabiting women in a series of multilevel logistic regression models. Results The share of sexually active, married and cohabiting women using modern contraceptives widely varied, from less than one percent in Kano, Yobe, and Jigawa states, to 40 percent in Osun state. Most of the states with low contraceptive prevalence rates also ranked low on womens socioeconomic attributes. Results of multilevel logistic regression analyses showed that women residing in states with greater shares of women with secondary or higher education, higher female labor force participation rates, and more women with health care decision-making power, had significantly higher odds of using modern contraceptives. Differences in womens participation in health care decisions across states remained significantly associated with modern contraceptive use, net of individual-level socioeconomic status and other covariates of modern contraceptive use. Conclusion Understanding of state variations in contraceptive use is crucial to the design and implementation of family planning programs. The findings reinforce the need for state-specific family planning programs in Nigeria. PMID:26258578

  7. Update in adolescent contraception.

    PubMed

    Lara-Torre, Eduardo

    2009-03-01

    Pregnancy rates in the United States seem to have stabilized in the past decade but continue to be higher than those in other industrialized nations. Although abstinence and barrier methods are available and efficient in preventing pregnancy, a comprehensive approach is a better choice when counseling patients on available options. The new approach to old contraceptive methods provides new alternatives to adolescents seeking safe and reliable methods. The availability and proved safety with longterm reversible contraceptive methods, such as the intrauterine system and subdermal implant, may allow adolescents to make better choices in preventing pregnancy. Future efforts in research should concentrate on finding the reasons why adolescents are at increased risk for unplanned pregnancy and solutions for this problem. Future contraceptive technology continues to focus on safety and convenience to facilitate the use of contraceptives in adolescents. PMID:19344851

  8. Contraception survey: Denmark 1988.

    PubMed

    Osler, M; Riphagen, F E

    1990-11-01

    In 1988 a survey** was conducted in 1,033 women living in Denmark, whose ages ranged from 15 to 44 years. The main aims of the study were to identify the influence, if any, of demographic and socioeconomic factors on contraceptive use and to assess the women's knowledge of selected facts concerning their own fertility. The study's additional objectives were to gain insight into factors influencing communication on the subject of contraception, such as advice obtained from professional counsellors, general information dissemination and discussion between partners, and to investigate women's attitudes and opinions regarding contraceptive methods and their use. The results are discussed in relation to the findings of other studies on the use of contraceptives both worldwide and in a number of European countries. The Danish findings are also examined in the context of possible action to reduce the relatively high rate of legally induced abortions in Denmark. PMID:2272181

  9. Contraceptive Evaluation.

    ERIC Educational Resources Information Center

    Hulka, Barbara S.; And Others

    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…

  10. Contraceptive Evaluation.

    ERIC Educational Resources Information Center

    Hulka, Barbara S.; And Others

    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

  11. Hormonal contraception and sexual desire: A questionnaire-based study of young Swedish women.

    PubMed

    Malmborg, Agota; Persson, Elin; Brynhildsen, Jan; Hammar, Mats

    2016-04-01

    Objectives The aim of the study was to determine whether a decrease in sexual desire is more prevalent among women using hormonal contraception than among women using hormone-free contraception, and whether a decrease increases the risk of changing to another contraceptive method. Methods A validated questionnaire was posted to 3740 women (aged 22, 25 or 28 years) living in Sweden. Descriptive statistics were used to present the results; differences between groups were tested using χ(2) analyses. A multiple logistic regression model was used for analysis of possible confounders. Results The response rate was 50%. The majority (81%) of respondents used some kind of contraception, and 88% were generally satisfied with the method used. Regardless of the type of method, 27% of hormonal contraceptive users reported a decrease in sexual desire that they attributed to their use of hormonal contraception, whereas only 12% of women using hormone-free contraception reported a decrease in sexual desire (p<0.01). This twofold risk of a decrease in sexual desire was shown in the multiple regression analysis to be independent of age group, depression, BMI, educational level and parity. However, having a partner was found to be a factor of equal importance: women with partners experienced reduced desire twice as often as women without partners. The observed odds ratio for planning to stop hormonal contraception or to change to a different type due to reduced desire was 8.16 (95% confidence interval 6.65-10.1) among women who had had the same experience during a previous period of hormonal contraceptive use. Conclusions Women using hormonal contraception were more likely to experience reduced sexual desire compared with women using hormone-free contraception. Experiencing reduced desire was a strong predictive factor for women to change contraceptive method. PMID:26406399

  12. Intrauterine contraception.

    PubMed

    Whaley, Natalie S; Burke, Anne E

    2015-11-01

    Intrauterine devices (IUDs) are effective, reversible forms of contraception with high patient satisfaction and continuation. IUDs can be safely used by most women and should be considered the first-line method of contraception for all women. This descriptive review will discuss the clinical issues associated with IUDs - including management of side effects, noncontraceptive uses and insertion and removal. When the burdens of cost are removed, women are more likely to select and IUDs. Health policy changes that increase insurance coverage for contraception will improve access to IUDs. IUDs remain an underutilized form of contraception in USA and efforts to improve availability and access to long-acting reversible contraception methods is needed to optimize their use. PMID:26626857

  13. Contraceptive Equity

    PubMed Central

    Temkin, Elizabeth

    2007-01-01

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

  14. Rationale and Enrollment Results for a Partially Randomized Patient Preference Trial to Compare Continuation Rates of Short-Acting and Long-Acting Reversible Contraception

    PubMed Central

    Hubacher, David; Spector, Hannah; Monteith, Charles; Chen, Pai-Lien; Hart, Catherine

    2014-01-01

    Objectives Most published contraceptive continuation rates have scientific limitations and cannot be compared; this is particularly true for dissimilar contraceptives. This study uses a new approach to determine if high continuation rates of long-acting reversible contraception (LARC) and protection from unintended pregnancy are observable in a population not self-selecting to use LARC. Study Design We are conducting a partially randomized patient preference trial to compare continuation rates of short-acting reversible contraception (SARC) and LARC. Only women seeking SARC were invited to participate. Participants chose to be in the preference cohort (self-selected method use) or opted to be randomized to SARC or LARC; only those in the randomized cohort received free product. We compared participant characteristics, reasons for not trying LARC previously, and the contraceptive choices that were made. Results We enrolled 917 eligible women; 57% chose to be in the preference cohort and 43% opted for the randomized trial. The preference and randomized cohorts were similar on most factors. However, the randomized cohort was more likely than the preference cohort to be uninsured (48% versus 36%, respectively) and to cite cost as a reason for not trying LARC previously (50% versus 10%) (p<0.01 for both comparisons). In the preference cohort, fear of pain/injury/side effects/health risks were the predominant reasons (cited by over 25%) for not trying LARC previously (p<0.01 in comparison to randomized cohort). Conclusions Enrollment was successful and the process created different cohorts to compare contraceptive continuation rates and unintended pregnancy in this ongoing trial. The choices participants made were associated with numerous factors; lack of insurance was associated with participation in the randomized trial. Implications This partially randomized patient preference trial will provide new estimates of contraceptive continuation rates, such that any benefits of LARC will be more easily attributable to the technology and not the user. Combined with measuring level of satisfaction with LARC, the results will help project the potential role and benefits of expanding voluntary use of LARC. PMID:25500324

  15. College Students' Perceived Disease Risk versus Actual Prevalence Rates

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  16. College Students' Perceived Disease Risk versus Actual Prevalence Rates

    ERIC Educational Resources Information Center

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

    2012-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2010-05-01

    Functional necessity to use a particular range of dose rate and total dose of γ-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 γ-dose rate and 2.0-2.4 kGy γ-total doses is suitable for the desirable in vivo performance of the contraceptive copolymer.

  18. Hormonal contraception and cardiovascular system.

    PubMed

    Brito, Milena Bastos; Nobre, Fernando; Vieira, Carolina Sales

    2011-04-01

    Hormonal contraception is the most widely used method to prevent unplanned pregnancies. The literature has shown an association between cardiovascular risk and use of hormone therapy. With the purpose of providing better guidelines on contraception methods for women with risk factors for cardiovascular disease, we have reviewed the literature on the subject. This review describes the latest data from the scientific literature concerning the influence of hormonal contraceptives on arterial thrombosis, venous thrombosis and systemic high blood pressure, which are diseases that have become increasingly prevalent among young females. PMID:21359483

  19. Family planning through private practitioners: characteristics of Kenyan contraceptive acceptors.

    PubMed

    Rogo, K O

    1990-01-01

    Kenya has one of the highest population growth rates in the world. Innovative programs are therefore called for to help curb the fast population growth rate. The Kenya Medical Association started a new program of involving private physicians in the active provision of family planning services. A preliminary analysis shows that the program serves generally young, better educated women of low parity. Sixty-one percent of the clients are new acceptors and the oral contraceptive pill the most popular method. The level of education of the clients had marked influence on family size. Age, parity and marital status also influenced the pattern of contraceptive use. These preliminary results are discussed against the background of the 1984 Kenya Contraceptive Prevalence Survey findings and possible areas of improvement suggested. PMID:1968018

  20. Emergency Contraception

    MedlinePlus

    ... pills are currently available at drug stores or family planning clinics for anyone 17 or older without a ... plans cover the cost of emergency contraception and family planning clinics (such as Planned Parenthood) may charge much ...

  1. Emergency contraception.

    PubMed

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

    2013-03-01

    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

  2. Contraception and the obese woman

    PubMed Central

    Reifsnider, Elizabeth; Mendias, Nonie; Davila, Yolanda; Babendure, Jennie Bever

    2016-01-01

    Purpose Obesity has reached epidemic rates among U.S. women of reproductive age, many of whom want to use contraception. However, some forms of contraception can have adverse effects on an obese woman's health. This article explores risks of contraception available in the United States and provides clinical recommendations for use by obese women. Data sources Information was compiled by reviewing the scientific literature on contraception and female obesity using CINAHL, MEDLINE, PubMed search engines. Conclusions The evidence is largely supportive of combined oral contraceptive (COC) use in carefully screened obese women without known risks factors for cardiovascular disease. The efficacy of COCs may be slightly reduced in obese women because of increased body mass. Other types of hormonal contraceptives have varying safety and efficacy reports when used by obese women. Intrauterine devices do not have reduced efficacy nor increased risks for obese women but insertion may be more difficult. Obesity has no effect on efficacy of barrier methods of contraception. Implications Clinicians should conduct a careful history and physical exam with selected supporting laboratory tests when considering prescription of hormonal contraceptives for obese women. Obese women require health counseling to carefully follow directions for contraceptive use to avoid unintended pregnancy. PMID:24170564

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

    PubMed

    Zeng, Yingchun; Luo, Taizhen; Zhou, Ying

    2015-09-01

    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

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

    PubMed Central

    2014-01-01

    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 Κ 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

  5. Male contraception.

    PubMed

    Chao, Jing; Page, Stephanie T; Anderson, Richard A

    2014-08-01

    Clear evidence shows that many men and women would welcome new male methods of contraception, but none have become available. The hormonal approach is based on suppression of gonadotropins and thus of testicular function and spermatogenesis, and has been investigated for several decades. This approach can achieve sufficient suppression of spermatogenesis for effective contraception in most men, but not all; the basis for these men responding insufficiently is unclear. Alternatively, the non-hormonal approach is based on identifying specific processes in sperm development, maturation and function. A range of targets has been identified in animal models, and targeted effectively. This approach, however, remains in the pre-clinical domain at present. There are, therefore, grounds for considering that safe, effective and reversible methods of contraception for men can be developed. PMID:24947599

  6. Male contraception

    PubMed Central

    Chao, Jing; Page, Stephanie T.; Anderson, Richard A.

    2015-01-01

    Clear evidence shows that many men and women would welcome new male methods of contraception, but none have become available. The hormonal approach is based on suppression of gonadotropins and thus of testicular function and spermatogenesis, and has been investigated for several decades. This approach can achieve sufficient suppression of spermatogenesis for effective contraception in most men, but not all; the basis for these men responding insufficiently is unclear. Alternatively, the nonhormonal approach is based on identifying specific processes in sperm development, maturation and function. A range of targets has been identified in animal models, and targeted effectively. This approach, however, remains in the pre-clinical domain at present. There are, therefore, grounds for considering that safe, effective and reversible methods of contraception for men can be developed. PMID:24947599

  7. Intrauterine Contraception.

    PubMed

    Hsia, Jennifer K; Creinin, Mitchell D

    2016-05-01

    Currently, there are only two basic types of intrauterine devices (IUDs): copper and hormonal. However, other types of IUDs are under development, some of which are in clinical trials around the world. Continued development has focused on increasing efficacy, longer duration of use, and noncontraceptive benefits. This review discusses currently available intrauterine contraceptives, such as the Cu380A IUD and levonorgestrel-releasing intrauterine systems; novel intrauterine contraceptives that are available in select parts of the world including the intrauterine ball, low-dose copper products, frameless devices, and intrauterine delivery systems impregnated with noncontraceptive medication; and novel products currently in development. PMID:26947701

  8. Lifetime Prevalence Rates of Sleep Paralysis: A Systematic Review

    PubMed Central

    Barber, Jacques P.

    2011-01-01

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

  9. 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

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

    2014-02-01

    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

  10. [Male contraception].

    PubMed

    Khomasuridze, A G; Marshaniia, Z S

    1991-01-01

    Various methods of contraception in men are reviewed. One of the methods of contraception is the use of hormonal agents (estrogens, androgens, antiandrogens, progestins, or their combinations), which block spermatogenesis. More advantageous is the use of nonhormonal agents (alpha-chlorhydrine, 6-chloro-6-deoxyglucose, salsosulfapyridine), which act on the process of sperm maturation in the epididymis. Plant extracts show marked contraceptive activity in men. The preparation gossypol isolated from cotton seeds and roots was found to inhibit male fertility. Various isomers of gossypol decreased sperm mobility by inhibiting the mitochondrial respiratory chain. Major side-effect of gossypol was hepatotoxicity. Glycosides isolated from the herb Tripterigium Wilfordii (TW) were found to have the antifertility activity. The antifertility effect of TW glycosides was dose- dependent: large doses were shown to inhibit spermatogenesis, while small doses were found to decrease sperm motility and viability. TW glycosides were free of toxic side-effects. Another approach to regulation of male fertility is the use of surgical methods of contraception including vasectomy. Development of less invasive and reversible surgical methods showed effectiveness of subcutaneous occlusion of vas deferens with various chemical substances (calcium chloride, p-butyl-2-cyanoacrylate). The best results were achieved with high molecular weight medical polyurethane. PMID:2042728

  11. Advances in male contraception.

    PubMed

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

    2008-06-01

    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

  12. Advances in Male Contraception

    PubMed Central

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

    2008-01-01

    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

  13. Barriers to contraceptive use among women in Benin.

    PubMed

    Chae, Sophia; Woog, Vanessa; Zinsou, Cyprien; Wilson, Megan

    2015-01-01

    The Republic of Benin has made it a national priority to promote family planning as part of its efforts to reduce maternal and child mortality rates. In addition to preventing deaths, increased contraceptive use would help women and families achieve their desired number of children and have greater control over timing births. It would also help Benin meet its development goals, including reducing poverty and increasing women's education and earning levels, children's schooling and GDP per capita. Key Points. (1) Although Benin's government promotes family planning, more needs to be done to meet the country's goal of increasing contraceptive prevalence to 20% by 2018. (2) As of 2012, modern contraceptive use remains low. Only 7% of married women and 23% of unmarried sexually active women use modern methods. (3) Unmet need has increased since 2006, from 27% to 33% among married women and from 35% to 50% among sexually active unmarried women. (4) Among married women with unmet need, the most commonly cited reasons for contraceptive nonuse are fear of side effects/health concerns (22%) and opposition to use (22%). In contrast, never-married women with unmet need cite not being married (42%), infrequent or no sex (21%) and fear of side effects/health concerns (17%). (5) Among women currently using sterilization, IUDs, implants, injectables or the pill, 57% report having been told about side effects when they received their method; 88% of those who were told about side effects were given instructions on how to deal with them. (6) Strategies to increase contraceptive use include improving the availability and quality of contraceptive services, increasing knowledge of family planning, and addressing social and cultural barriers to contraception. PMID:26702466

  14. Prevalence rates for depression by industry: a claims database analysis

    PubMed Central

    Alterman, Toni; Bushnell, P. Timothy; Li, Jia; Shen, Rui

    2015-01-01

    Purpose To estimate and interpret differences in depression prevalence rates among industries, using a large, group medical claims database. Methods Depression cases were identified by ICD-9 diagnosis code in a population of 214,413 individuals employed during 2002–2005 by employers based in western Pennsylvania. Data were provided by Highmark, Inc. (Pittsburgh and Camp Hill, PA). Rates were adjusted for age, gender, and employee share of health care costs. National industry measures of psychological distress, work stress, and physical activity at work were also compiled from other data sources. Results Rates for clinical depression in 55 industries ranged from 6.9 to 16.2 %, (population rate = 10.45 %). Industries with the highest rates tended to be those which, on the national level, require frequent or difficult interactions with the public or clients, and have high levels of stress and low levels of physical activity. Conclusions Additional research is needed to help identify industries with relatively high rates of depression in other regions and on the national level, and to determine whether these differences are due in part to specific work stress exposures and physical inactivity at work. Clinical significance Claims database analyses may provide a cost-effective way to identify priorities for depression treatment and prevention in the workplace. PMID:24907896

  15. Contraception for adolescents.

    PubMed

    Yen, Sophia; Martin, Susanne

    2013-02-01

    CME EDUCATIONAL OBJECTIVES: 1.Identify and explain the four currently available methods of emergency contraception.2.Discuss the risk and benefits of intrauterine devices as a first-line option for contraception in adolescents.3.Review strategies for explaining the most common contraceptive methods to an adolescent. The US has the highest pregnancy rate of any industrialized nation, approximately twice that of Canada, four times that of France, and eight times that of Japan or Italy.1 In recent years, the rate has declined, partially due to delayed coitarche (age of onset of vaginal sexual intercourse) but mainly due to greater use of contraception.2 Per the 2011 Youth Risk Behavior Survey (a national survey of about 15,000 youth in schools), 33% of high school freshmen, 44% of sophomores, 53% of juniors, and 63% of seniors have had vaginal sexual intercourse. To prevent unplanned and unwanted teenage pregnancies, which have negative consequences on a teenager's health and future, pediatricians must be able to provide birth control or at least know where to refer their patients in need. PMID:23379400

  16. Contraceptive use in Indonesia: a history of the programme and the characteristics of users.

    PubMed

    Samosir, O B

    1992-12-01

    In Indonesia, President Suharto instituted a population policy in the late 1960s to achieve national development goals. The government also introduced education, health, and economic-oriented development programs. Since then, it has continued to provide political, legal, moral, administrative, and financial support to the national family planning (FP) program. The program was first introduced in the most populous provinces of Java and Bali. It eventually spread to the remaining provinces. It has 3 component programs to achieve national population goals: on extension program (IEC activities and free contraceptives), program maintenance (community-based distribution), and an institutionalization program (integrated programs, population education, and recruiting community leaders). In 1987, the FP Self-Reliance and Blue Circle Campaign programs began to turn FP responsibilities over to communities and individuals. Between 1967 and 1981, the total fertility rate (TFR) fell from 5.61 to 4.06. The greatest fertility declines were in Bali (48.11%) and North Sulawesi (47.2%). An analysis of 1987 National Indonesian Contraceptive Prevalence Survey data shows that the TFR fell from 4.3 to 3.5 (23%) between 1984 and 1987. Between 1980 and 1987, the contraceptive use rate rose from 27 to 48%. Java and Bali had the highest contraceptive user rates. Large family size had a significant positive effect on contraceptive use. Educated women were more likely to use contraceptives than uneducated women, especially in Outer Java-Bali regions. In some regions, the husband's education affected contraceptive use. Muslim women were less likely to use contraceptives than other women in Bali and Outer Java-Bali I. Even though urban women had the highest use rates, the FP program was more successful in rural areas. The success of the national FP program and other development programs accounted for the fertility decline as well as the decline in mortality, resulting in a fall in the population growth rate. PMID:12159255

  17. Gambling disorder: estimated prevalence rates and risk factors in Macao.

    PubMed

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

    2014-12-01

    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. PMID:25134026

  18. Contraception for adolescents after abortion.

    PubMed

    Sedlecky, Katarina; Stanković, Zoran

    2016-02-01

    Introduction Preventing repeated unplanned pregnancy among adolescents is still a challenge because many of them fail to use effective contraception after abortion. Objective To review currently recommended options of methods and counselling for effective prevention of repeat pregnancies in adolescents. Methods Review of the literature that was identified through the Medline, ScienceDirect, Google and Popline databases and relevant expert opinions. Results Counselling needs to be adapted to the needs, values and lifestyle of adolescents. The best results are achieved with nondirective or active contraceptive counselling, followed by regular check-ups and cautious and attentive approach in the management of doubts, prejudices and side effects related to the contraceptive chosen. Adolescents should initiate contraception immediately after abortion: the motivation for choosing an efficacious method is highest at that time; resumption of ovulation following induced abortion occurs on average after three weeks; more than half of these girls will resume sexual activity within two weeks after pregnancy termination. Long-acting reversible contraception use during adolescence is safe and most effective. However, achieving a high long-term continuation rate is especially challenging in adolescents; this is due to developmental and environmental characteristics that influence their contraceptive behaviour. Conclusion Adolescents should immediately after abortion initiate a reliable contraceptive method, preferably one whose efficacy is not user-dependent. Providing an appropriate health care would contribute to achieving continuity in the prevention of repeat pregnancy. PMID:26463183

  19. Contraception and Birth Control

    MedlinePlus

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

  20. Emergency Contraception Website

    MedlinePlus

    Text Only Full media Version Get Emergency Contraception NOW INFO about Emergency Contraception Q&A about Emergency Contraception Español | Arabic Find a Morning After Pill Provider Near You This ...

  1. Contraceptive use and distribution of high-risk births in Nigeria: a sub-national analysis

    PubMed Central

    Akinyemi, Akanni; Adedini, Sunday; Hounton, Sennen; Akinlo, Ambrose; Adedeji, Olanike; Adonri, Osarenti; Friedman, Howard; Shiferaw, Solomon; Maïga, Abdoulaye; Amouzou, Agbessi; Barros, Aluisio J. D.

    2015-01-01

    Background Family planning expansion has been identified as an impetus to harnessing Nigeria's demographic dividend. However, there is a need for data to address pockets of inequality and to better understand cultural and social factors affecting contraceptive use and health benefits. This paper contributes to addressing these needs by providing evidence on the trends and sub-national patterns of modern contraceptive prevalence in Nigeria and the association between contraceptive use and high-risk births in Nigeria. Design The study utilised women's data from the last three Demographic and Health Surveys (2003, 2008, and 2013) in Nigeria. The analysis involved descriptive, bivariate, and multivariate analyses. The multivariate analyses were performed to examine the relationship between high-risk births and contraceptive use. Associations were examined using Poisson regression. Results Findings showed that respondents in avoidable high-risk birth categories were less likely to use contraceptives compared to those at no risk [rate ratio 0.82, confidence interval: 0.76–0.89, p<0.001]. Education and wealth index consistently predicted significant differences in contraceptive use across the models. Conclusions The results of this study suggest that women in the high-risk birth categories were significantly less likely to use a modern method of contraception relative to those categorised as having no risk. However, there are huge sub-national variations at regional and state levels in contraceptive prevalence and subsequent high-risk births. These results further strengthen evidence-based justification for increased investments in family planning programmes at the state and regional levels, particularly regions and states with high unmet needs for family planning. PMID:26562145

  2. Contraception and society.

    PubMed

    Diczfalusy, E

    2002-12-01

    When an idea meets the exigencies of an epoch, it becomes stronger than any form of political power and it becomes the common property of humankind. Such an idea was the development of contraceptives. In retrospect, the invention of contraceptives was as fundamental for the evolution of humankind as the invention of the wheel; today more than 550 million couples are using contraceptive methods. The large-scale use of contraceptives triggered the most powerful social revolutions of a century in reproductive health and gender equity, and substantially contributed to an unparalleled demographic change, characterized by a rapid aging of populations. One of the important reasons for population aging is a significant decline in fertility rates, resulting in gradually changing population structures with fewer and fewer children and more and more elderly persons. The causes underlying these demographic changes are complex and manifold; they reflect major societal changes of historical dimensions. Many of our institutions cater increasingly for a population structure that no longer exists. There is therefore an increasing need for institutional reforms in social security, health care, housing and education. In addition, several surveys conducted in the developed world have indicated an erosion of confidence in our basic institutions, e.g. courts and justice, the Church and Parliament. Whereas modem sociologists are concerned about an increase in crime, decrease in trust and depleted social capital, one can also observe an accelerated perception of our global destiny and a re-awakening of the moral impulse with a strong demand for increased transparency in public affairs. Also, various global communities have assumed a growing importance. It can be predicted that international professional communities, such as the European Society of Contraception, will play an increasingly important future role in influencing policies in general and health policies in particular. because of their profound commitment to the improvement of the human condition by the judicious use of new scientific information. PMID:12648291

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

    PubMed Central

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

    2013-01-01

    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

  4. Contraception in the Developing World: Special Considerations.

    PubMed

    Schivone, Gillian B; Blumenthal, Paul D

    2016-05-01

    The United States Agency for International Development (USAID) estimates that there are 225 million women and girls with unmet contraceptive need yearly. Unmet need for contraception is defined as women who desire a delay in childbearing and are not using a modern method of contraception. It is projected that providing contraception to these women would avert 36 million abortions, 70,000 maternal deaths, and 52 million unintended pregnancies overall. In the past 30 years, there has been an increase both in population and in contraception use in the developing world. As a result, it is estimated that in 2015 there were 500 million contraceptive users in developing countries, which is nearly double the prevalence in 2000. Unfortunately, women and girls in developing nations still face many obstacles in obtaining modern methods of contraception. Particular challenges in the developing world include lack of access due to inadequate number of trained providers, fewer method options, and "stock-outs" of contraceptive supplies. Innovative strategies for decreasing unmet need will have to address these challenges, and will necessarily involve programmatic solutions such as community-based distribution and social marketing campaigns. Additionally, increasing uptake of long-acting reversible contraceptive methods will be essential for achieving the goal of decreasing unmet need. PMID:26956690

  5. Evidence from peninsular Malaysia of breastfeeding as a contraceptive method.

    PubMed

    Rao, S R

    1992-01-01

    This report examines Malaysian women's perceptions of the contraceptive effect of breastfeeding, the determinants of their perceptions, and any effect these perceptions might have on nursing duration and contraceptive use. The report also considers whether women are consciously replacing breastfeeding with modern contraceptive methods. Data from the 1976 Malaysian Family Life Survey are analyzed, and the author concludes that Malaysian women do perceive that breastfeeding has a contraceptive effect, but that this perception is not universal. Ethnicity and desire for a particular family size are the most significant determinants of this perception. Finally, Malaysian women's recognition of the contraceptive effect of nursing does not influence either the duration of their breastfeeding or their adoption of contraception. Malaysian women may not be abandoning breastfeeding to adopt contraception. More probably, breastfeeding declines and contraceptive prevalence increases with modernization. PMID:1293861

  6. Postcoital contraception.

    PubMed

    McLaren, H C

    1977-02-01

    My colleague Dr. C.L. Brewer (January 15, p. 169) is within his rights to ask for a precise definition of abortion and contraception. I define abortion as the deliberate destruction of the embryo once it is embedded in the uterus. The absolutist on the abortion issue, until he is sure that an IUD never works by destroying an embedded embryo, must logically eschew this technique, advising his patient as to his ethical objections. She may then seek other advice once she has the facts. However, to insist that those who advise an IUD with the motive of contraception cannot herefore object to, say, intrauterine saline aimed at the destruction of a moving 27-week fetus is, in my view, stretching his argument. With further stretching it could be carried to absurdity in the rubella-early pregnancy dilemma: why not deliver the child, examine it carefully, and then if imperfect kill it with a silver hammer? Unthinkable, even if logical. Still, Dr. Brewer has a point and (with me) no doubt he will sympathize with Pope John and his advisers in their support for family spacing only by the avoidance of the fertile days - esthetically admirable but, alas, not always effective. How absurd the Catholic Church would now look if 10 years ago it had blessed the IUD only to find that it may operate not only by preventing the embedding of the zygot but by destroying it in situ - by definition an abortion. The future may settle the debate with hormones which convert the endometrium to a nonreceptive state so that a fetus is never embedded in the womb. Even better, we may develop a male hormone which prevents sperm from penetrating the ovum. Meantime, motive is important: contraception is not abortion and our abortionists should not dress up as delayed contraceptors. (Editor's note: This correspondence is now closed.) PMID:837109

  7. Contraceptive Use and Pregnancy Outcomes among Opioid Drug-Using Women: A Retrospective Cohort Study

    PubMed Central

    Cornford, Charles S.; Close, Helen J.; Bray, Roz; Beere, Deborah; Mason, James M.

    2015-01-01

    Objective The contraceptive needs of illicit opioid users differ from non-drug users but are poorly understood. The aim of this study was to describe contraceptive use and pregnancy outcomes in opioid-using women, and to examine their association with a range of risk factors. Method This retrospective cohort study used UK general practice records, Treatment Outcomes Profile and National Drug Treatment Monitoring System data, and a nested data validation exercise. A cohort of 376 women aged 20–61 years were in active treatment for opioid addiction in October 2010 at two specialised primary care practices in North-East England. Outcomes were age-adjusted prevalence estimates for contraceptive use and pregnancy outcomes in users of illicit opioids. The association between lifestyle-related risk factors and contraception was explored. Results Drug-using women made lower use of planned (non-condom) contraception (24% vs 50%, p<0.001), had more frequent pregnancy terminations (0.46 vs. 0.025, p = 0.004) and higher annual incidence of chlamydia (1.1% vs. 0.33%, p<0.001), when compared with age-matched population data. Specifically, there was low use of oral contraceptives (4% vs. 25%, p<0.001), IUCD (1% vs. 6%, p<0.001), and sterilisation (7% vs. 6%, p = 0.053), but higher rates of injectable contraceptives (6% vs. 3%, p = 0.003). A total of 64% of children aged <16 years born to this group did not live with their mother. No individual risk factor (such as sex-working) significantly explained the lower use or type of non-condom contraception. Conclusions This is the first study to describe planned contraceptive use among drug-users, as well as the association with a range of risk factors and pregnancy outcomes. The low uptake of planned contraception, set against high rates of terminations and sexually transmitted disease demonstrates the urgent clinical need to improve contraceptive services, informed by qualitative work to explore the values and beliefs influencing low contraceptive uptake. PMID:25739018

  8. Contraceptive vaccines.

    PubMed

    Aitken, R J; Paterson, M; Koothan, P T

    1993-01-01

    Three major approaches to contraceptive vaccine development are being pursued at the present time. The most advanced approach, which has already reached the stage of phase 2 clinical trials, involves the induction of immunity against human chorionic gonadotrophin (hCG). Vaccines are being engineered based on conjugates incorporating tetanus or diphtheria toxoid linked to a variety of hCG-based peptides centred on the beta-subunit of this molecule. Clinical trials have revealed that such preparations are capable of stimulating the production of anti-hCG antibodies. However, the long term consequences of such immunity in terms of safety or efficacy are, as yet, unknown. The alternative approaches to contraceptive vaccine development involve the induction of immunity against gamete-specific antigens found on the surface of the human spermatozoon or the zona pellucida. There is an abundance of experimental and clinical data to suggest that this approach is feasible although the biochemical characterization and synthesis of candidate antigens is still incomplete. PMID:8324618

  9. Spousal communication on family planning and perceived social support for contraceptive practices in a sample of Malaysian women

    PubMed Central

    Najafi-Sharjabad, Fatemeh; Rahman, Hejar Abdul; Hanafiah, Muhamad; Syed Yahya, Sharifah Zainiyah

    2014-01-01

    Background: In Malaysia, contraceptive prevalence rate (CPR) during past three decades has been steady, with only 34% of women practicing modern contraception. The aim of this study was to determine the factors associated with modern contraceptive practices with a focus on spousal communication and perceived social support among married women working in the university. Materials and Methods: A cross-sectional study was carried out using self-administered structured questionnaire. The association between variables were assessed using Chi-square test, independent sample t-test, and logistic regression. Results: Overall, 36.8% of women used modern contraceptive methods. Significant association was found between contraceptive practice and ethnicity (P = 0.003), number of pregnancies (P < 0.001), having child (P = 0.003), number of children (P < 0.001), positive history of mistimed pregnancy (P = 0.006), and experience of unwanted pregnancy (P = 0.003). The final model showed Malay women were 92% less likely to use modern contraception as compared to non-Malay women. Women who discussed about family planning with their spouses were more likely to practice modern contraception than the women who did not [odds ratio (OR): 2.2, Confidence Interval (CI): 1.3–3.7]. Those women with moderate (OR: 4.9, CI: 1.6–10.8) and strong (OR: 14, CI: 4.5–26.4) perception of social support for contraceptive usage were more likely to use modern contraception than the women with poor perception of social support. Conclusion: Spousal communication regarding family planning would be an effective way to motivate men for supporting and using contraceptives. Family planning education initiatives should target both men and women, particularly high-risk cases, for promoting healthy timing and spacing of pregnancies. Ethnic disparities need to be considered in planning reproductive health programs. PMID:25949248

  10. Contraceptive practices amongst HIV-positive women on antiretroviral therapy attending an ART clinic in South Africa

    PubMed Central

    Ross, Andrew; van der Linde, Stephan

    2013-01-01

    Abstract Background Effective contraceptive practices amongst HIV-positive women of reproductive age have been shown to reduce mother-to-child transmission of HIV by preventing unplanned pregnancies. However, most antiretroviral therapy (ART) programmes focus on treatment, neglecting comprehensive contraceptive services. This results in a high frequency of pregnancies amongst HIV-positive women attending the ART clinic of a regional hospital north of Durban. Objectives This research aimed to explore contraceptive use amongst HIV-positive women attending an ART clinic by determining, (1) prevalence of contraceptive use, (2) pregnancy rate, (3) contraceptive preferences and (4) factors associated with contraceptive use. Methods In this observational, analytical, cross-sectional study of 420 women, aged 15 to 49 years, participants were selected by systematic random sampling. They completed standardised questionnaires. Results Of all participants, 95% of the participants used contraception. Factors associated with contraceptive practice were knowledge of HIV status 292 (72.8%), health worker advice 84 (20.9%), and spousal insistence 33 (8.2%). Of the 130 women (31%) who had fallen pregnant whilst on ART, 73 (56.2%) said that the pregnancy had been unplanned, whilst 57 (43.8%) had wanted to fall pregnant because of: partner's insistence (45.6%), desire for a child (36.8%), desire to conceal HIV status (15.8%), not wanting to die childless (5.3%), and death of a previous child (1.8%). Conclusion Contraceptive use amongst these women was high but the number of pregnancies is a cause for concern. Information regarding contraceptive use should therefore be provided at all ART clinics.

  11. Adolescents and oral contraceptives.

    PubMed

    Sanfilippo, J S

    1991-01-01

    Oral contraceptive (OC) options for adolescents are provides. Clarification for those desiring a birth control method is necessary and the benefits of decreased acne and dysmenorrhea with low dose OCs should be stressed along with the importance of compliance. A community effort is suggested to communicate the sexual and contraceptive alternatives, including abstinence and outercourse (sexual stimulation to orgasm without intercourse). Attention is given to concerns associated with teenage sexual activity, prevention of adolescent pregnancy, contraceptive options for the adolescent patient, adolescent attitudes toward birth control OCs, management of the adolescent OC user, manipulation of steroid components of OCs to respond to adolescent concerns, and other hormonal contraceptive options such as minipills or abstinence. The text is supplemented with tables: the % of US women by single years of age for 1971, 1976, 1979, and 1982; comparative pregnancy and abortion rates for the US and 5 other countries; federal cost for teen childbearing; adolescent nonhormonal contraceptive methods (advantages, disadvantages, and retail cost); checklist to identify those at risk for noncompliance with OCs; hormonal side effects of OCs; risks from OCs to adolescents; and benefits of OCs. Concern about adolescent pregnancy dates back to Aristotle. A modern profile shows girls form single-parent families are sexually active at an earlier age, adolescent mothers produce offspring who repeat the cycle, victims of sexual abuse are more likely to be sexually active, and teenagers in foster care are 4 times more likely to be sexually active and 8 times more likely to become pregnant. Prevention involves a multifaceted approach. OCs are the most appropriate contraceptive choice for adolescents. Frequency of intercourse is closely associated with OC use after approximately 15 months of unprotected sexual activity. At risk for noncompliance variables are scales of personality development (autonomy, self-esteem, locus of control), life expectations (marriage, college, career), dating behavior, age at 1st intercourse, perceived risk for becoming pregnant, personal attributes (sex, birth control, acquisition of birth control, pregnancy, parents' and peers' feelings toward sex and birth control), and previous experiences with birth control. PMID:1679420

  12. Contraceptive use and method choice among women with opioid and other substance use disorders: A systematic review

    PubMed Central

    Terplan, Mishka; Hand, Dennis J.; Hutchinson, Melissa; Salisbury-Afshar, Elizabeth; Heil, Sarah H.

    2016-01-01

    Aim To systematically review the literature on contraceptive use by women with opioid and other substance use disorders in order to estimate overall contraceptive use and to examine method choice given the alarmingly high rate of unintended pregnancy in this population. Method Pubmed (1948–2014) and PsycINFO (1806–2014) databases were searched for peer-reviewed journal articles using a systematic search strategy. Only articles published in English and reporting contraceptive use within samples of women with opioid and other substance use disorders were eligible for inclusion. Results Out of 580 abstracts reviewed, 105 articles were given a full-text review, and 24 studies met the inclusion criteria. The majority (51%) of women in these studies reported using opioids, with much smaller percentages reporting alcohol and cocaine use. Across studies, contraceptive prevalence ranged widely, from 6%–77%, with a median of 55%. Results from a small subset of studies (N = 6) suggest that women with opioid and other substance use disorders used contraception less often than non-drug-using comparison populations (56% vs. 81%, respectively). Regarding method choice, condoms were the most prevalent method, accounting for a median of 62% of contraceptives used, while use of more effective methods, especially implants and intrauterine devices (IUDs), was far less prevalent 8%. Conclusions Women with opioid and other substance use disorders have an unmet need for contraception, especially for the most effective methods. Offering contraception services in conjunction with substance use treatment and promoting use of more effective methods could help meet this need and reduce unintended pregnancy in this population. PMID:25900803

  13. Advance Provision of Emergency Contraception for Adolescents

    ERIC Educational Resources Information Center

    Adamji, Jehan-Marie; Swartwout, Kathryn

    2010-01-01

    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…

  14. Trends and patterns of modern contraceptive use and relationships with high-risk births and child mortality in Burkina Faso

    PubMed Central

    Maïga, Abdoulaye; Hounton, Sennen; Amouzou, Agbessi; Akinyemi, Akanni; Shiferaw, Solomon; Baya, Banza; Bahan, Dalomi; Barros, Aluisio J. D.; Walker, Neff; Friedman, Howard

    2015-01-01

    Background In sub-Saharan Africa, few studies have stressed the importance of spatial heterogeneity analysis in modern contraceptive use and the relationships with high-risk births. Objective This paper aims to analyse the association between modern contraceptive use, distribution of birth risk, and under-five child mortality at both national and regional levels in Burkina Faso. Design The last three Demographic and Health Surveys – conducted in Burkina Faso in 1998, 2003, and 2010 – enabled descriptions of differentials, trends, and associations between modern contraceptive use, total fertility rates (TFR), and factors associated with high-risk births and under-five child mortality. Multivariate models, adjusted by covariates of cultural and socio-economic background and contact with health system, were used to investigate the relationship between birth risk factors and modern contraceptive prevalence rates (mCPR). Results Overall, Burkina Faso's modern contraception level remains low (15.4% in 2010), despite significant increases during the last decade. However, there are substantial variations in mCPR by region, and health facility contact was positively associated with mCPR increase. Women's fertility history and cultural and socio-economic background were also significant factors in predicting use of modern contraception. Low modern contraceptive use is associated with higher birth risks and increased child mortality. This association is stronger in the Sahel, Est, and Sud-Ouest regions. Even though all factors in high-risk births were associated with under-five mortality, it should be stressed that short birth spacing ranked as the highest risk in relation to mortality of children. Conclusions Programmes that target sub-national differentials and leverage women's health system contacts to inform women about family planning opportunities may be effective in improving coverage, quality, and equity of modern contraceptive use. Improving the demand satisfied for modern contraception may result in a reduction in the percentage of women experiencing high-risk births and may also reduce child mortality. PMID:26562142

  15. Oral contraceptives: Pt. 2.

    PubMed

    1978-01-01

    This discussion of oral contraceptives (OCs) presents information on the following: types of steroidal contraception OCs, injectable contraceptive agents, implants, intravaginal rings, IUD bearing steroids, male pills, intracervical devices, contraceptive bracelets, and intranasal administration of hormones); guidelines for adolescent usage (why adolescents use OCs, common medical concerns, assessment, prescribing, educating for user effectiveness, and the length of time that the adolescent can use OCs); the marketing of OCs; attitudes toward OCs; the effect of OCs on insulin requirements in diabetes; mortality among OC users; assessing new knowledge of mortality trends and OCs; beneficial and adverse effects; sexual and psychological response to OCs; chromosomal abnormalities and OCs; ectopic pregnancies and the progestogen only pill; liver tumors and OCs; cancer and OCs; eye conditions and OCs; and postpill amenorrhea and infertility. Most adolescents choose OCs as their initial contraceptive method because it is probably the only method of which they have much knowledge. Most adolescents lack the needed level of sexual maturity and sexual sophistication to pause to insert a diaphrage or to use a condom. Another attraction of OCs is reliability. At this time 12 major companies based in 8 countries (excluding China) produce and market OCs. Basically either of 2 estrogens, ethinyl estradiol and mestranol, are used in combination with about 6 different progestogens. Attitudes vary greatly and range from total acceptance to total rejection. Despite some negative views about OC, 32.2% of Australian women in childbearing years are using OCs indicating a high degree of acceptance. The new data available indicate strongly that the hazards of using OCs are somewhat greater than previously suspected. In 1977 the Royal College of General Practitioners reported a death rate from circulatory disease which was in OC users 4.7 times that of women who had never used OCs. The deaths were concentrated among the older women, among cigarette smokers, and those with a long duration of OC use, i.e., over 5 years. Available evidence suggests that OCs do affect a number of transmitter amines in the brain and this might be responsible for the depressed mood in some patients. Critical review of the literature leaves one skeptical concerning claims of either positive or negative influences on the libido. PMID:12338652

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

    PubMed

    Hildebrandt, V H

    1995-06-01

    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 at least 50 respondents for each. A total of 26.6% of the workers reported back pain quite often. Almost 2% reported absence from work in the last two months, and 4% considered their back pain to be a chronic disabling disease. There was a substantial variation in prevalence rate of low-back pain between trades and professions ranging from 12% to 41%. Trades with relatively high prevalence rates were found to be the building materials industry, the construction industry and road transportation, and the wholesale industry. Trades with relatively low prevalence rates were found to be banking, public administration and commercial services. Workers in the construction industry and supervisory production workers, plumbers, drivers and cleaners have a relatively high prevalence rate of back pain. Chemists, scientists, bookkeepers, secretaries and administrative professions have a relatively low prevalence rate of back pain. It is concluded that high prevalence rates of back pain are found in particular in non-sedentary professions. Priorities in prevention of back pain should be directed towards the group with relatively high prevalence rates identified above. PMID:7758450

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

    ERIC Educational Resources Information Center

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

    2012-01-01

    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

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

    ERIC Educational Resources Information Center

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

    2012-01-01

    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…

  19. Contraception in lactating women.

    PubMed

    Díaz, S; Croxatto, H B

    1993-12-01

    Lactating women need contraception after first menses, supplementation or 6 months postpartum, or before, according to personal or programmatic reasons. Non-hormonal methods have no influence on lactation and are the first choice. Intrauterine devices (IUDs) inserted during amenorrhea are safe and show good continuation rates. Progestin-only methods do not affect breast-feeding and should be used after 6 weeks to prevent transference of orally active steroids to the newborn. Progesterone rings and Nestorone implants are effective new methods, that use orally inactive steroids. PMID:8286695

  20. Contraception for adolescents.

    PubMed

    Ott, Mary A; Sucato, Gina S

    2014-10-01

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

  1. Contraceptives available by prescription.

    PubMed

    Huff, J E; Hernandez, L

    1974-05-01

    The article presents a comprehensive review of the common contraceptive methods. Contraceptive preferences are ranked in tables by physicians and patients with unanimity on oral contraceptives as first preference. Tables also show combination oral contraceptives, sequential oral, and pregestin only contraceptives by trade name, manufacturer, number of tablets per dispensing unit, and progestogen and/or estrogen content. Women using sequential pills are seen to run a greater risk of thromboembolism. Discussion on contraceptive pills includes the effectiveness of various types of pills, the infertility mechanism, physicians' attitudes towards prescribing, risks, side effects and other reasons for nonuse, contraindications, and prescriptive precautions. IUDs are described and discussed regarding comparative effects and action of various types IUD, detractive aspects, precautions, and evaluation of the IUD as a contraceptive. Other contraceptives discussed are the diaphragm, cervical cap, sterilization, and abortion. PMID:4831214

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

    PubMed Central

    2014-01-01

    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

  3. Searching for Ideal Contraceptives.

    ERIC Educational Resources Information Center

    Djerassi, Carl

    1985-01-01

    Discusses the problem of adolescent pregnancy and focuses on improving contraception as a practical solution. Describes the advantages and disadvantages of existing methods (the condom, the pill, and the contraceptive sponge). Predicts that the development of a fundamentally new contraceptive, such as a monthly menses-inducer pill, will not occur…

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

    PubMed

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

    2014-01-01

    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

  5. Is effective contraceptive use conceived prenatally in Florida? The association between prenatal contraceptive counseling and postpartum contraceptive use.

    PubMed

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

    2012-02-01

    The objective of this study is to describe the prevalence of postpartum contraceptive use among women experiencing a live birth in Florida in 2004-2005. To examine the association between family planning counseling during prenatal care visits and the use of effective contraceptive methods among postpartum women. Matched data from Florida PRAMS and Vital Statistics were used (n = 3,962). Weighted logistic regression was used to determine the association between prenatal family planning counseling and effective postpartum contraceptive use. Odds ratios were adjusted for use of contraception prior to pregnancy, well-baby checkup, race, ethnicity, nativity, education, marital status, poverty level, stress before or during pregnancy, and parity. Women who reported discussing family planning with their prenatal care provider were more likely to use effective contraception postpartum (AOR: 1.5, 1.1-2.0) compared to women who did not report a discussion. Women who used contraception prior to pregnancy (AOR: 2.3, 1.7-3.2) and women who experienced no stress before or during pregnancy (AOR: 2.0, 1.2-3.4) were also more likely to use contraception in the postpartum period. A significant interaction was identified between family planning counseling during prenatal visits and maternal education. Stratum specific odds ratios for women who received prenatal family planning counseling were significant for women with less than high school education (AOR: 2.5, 1.3-5.1) and for women with high school education (AOR: 2.0, 1.2-3.4). Women reporting family planning counseling during prenatal care were more likely to use effective contraception postpartum. While women with high school or less than high school education levels benefited from prenatal family planning counseling, the greatest benefit was observed for women with less than high school education. Integrating family planning counseling into prenatal care may increase the use of effective contraceptive methods among postpartum women. PMID:21197562

  6. Is oral contraceptive associated with genital warts?

    PubMed Central

    Ross, J D

    1996-01-01

    OBJECTIVE: To measure the association between oral contraceptive use and the prevalence of genital warts in women. METHODS: Cross sectional case control study comparing oral contraceptive use in women with and without genital warts attending a city centre genitourinary medicine clinic controlling for recent sexual activity, the presence of other sexually transmitted infections, socio-economic class and history of pregnancy using a multivariate logistic regression model. RESULTS: After controlling for potential confounding variables women with genital warts were significantly more likely to be current users of the oral contraceptive pill (OR 1.7, 95% CI 1.3-2.2). CONCLUSION: The study suggests that women taking the oral contraceptive may be at increased risk of presenting with genital warts. Previously published papers provide some support for this hypothesis and potential biological mechanisms are discussed. PMID:8976847

  7. [Contraception and abortion: an update in 2015].

    PubMed

    Chung, D; Ferro Luzzi, E; Bettoli Musy, L; Narring, F

    2015-09-23

    Family doctors can play an important role in preventing unplanned pregnancies. This article addresses the different contraceptives methods available in Switzerland, which are classified in 2 groups and recommends using the GATHER approach (Greet, Ask, Tell, Help, Explain, Return) to promote compliance. LARC (long acting reversible contraceptives) can be recommended to any woman who needs a reliable birth control method. These contraceptives require minimum effort for high efficiency. Further explanation regarding the use of an emergency contraception must be provided when short action contraceptives are chosen. Switzerland's abortion rate is one of the lowest in the world. Medical abortion tends to be more and more prominent. Under certain circumstances, it can be self-administered at home. PMID:26591787

  8. Pressures influence contraceptive use.

    PubMed

    Keller, S

    1997-01-01

    Many adolescents are embarrassed or unwilling to take precautions against sexually transmitted diseases (STDs). In African countries polygamy or sex with older partners can increase for young women the risk of contracting HIV and other STDs. Their feelings of insecurity and lack of self-confidence prevents them from seeking reproductive health services and rejecting unwanted sexual advances. The Girls' Power Initiative in Nigeria offers confidence building meetings to girls 10-18 years old. It also teaches job skills. Through empowerment they realize their capacity to cope with their own prejudices and those in society. In Bangladesh girls are not allowed to leave their homes, ride a bicycle, or go to the marketplace alone. A Baltimore, Maryland, a family planning clinic provided contraceptive counseling, pregnancy testing, and referrals to 2 high schools during school hours for 3 years with the result of significantly reduced pregnancy rates afterwards. Specific skills to be taught to sexually active adolescents include the use of condoms and communication about contraceptive use and STD prevention with a partner. These programs also address the students' specific sexual histories and safe sex behavior. In New Orleans, Louisiana, of 228 pregnant adolescent women 86% said that they knew about contraception at the time they became pregnant, but only 16% reported using a method, which finding indicates the necessity to address psychological needs of youth. Pregnant adolescents often face psychological or social barriers, lack of family support, and inadequate pregnancy counseling. A Family Health International study of 519 adolescents 12-18 years old, who sought prenatal care or abortion-related emergency services in Fortaleza, Brazil, showed that 1 woman in every 5 would have preferred to delay the pregnancy. PMID:12292391

  9. Vaginal contraceptives still evolving.

    PubMed

    Pearson, R M

    1986-01-01

    The effort to develop vaginal contraceptives began in the distant past and is still underway today. 1000 years ago, South American Indians inserted into the vagina bark strips impregnated with quinine. In medieval times women used vaginal inserts of cloth soaked in honey or vinegar. Quinine pessaries were introduced into Europe in the late 1800s, and in the early 1900s investigators began to study the effects of various chemicals on sperm motility. Following World War II, surfactant spermicides which disrupt the sperm membrane were developed and marketed. Many of these preparations contained nonoxynol-9. Currently, the D-isomer of propranolol is being examined as a spermicidal contraceptive, and several bacteriocides, e.g., benzalkonium and chlorhexidine, are being developed as spermicides which reduce the penetrability of cervical mucus. Other chemicals being investigated act by inhibiting the acrosome reaction. Advantages of vaginal contraceptives are that they are inexpensive, reversible, and relatively safe and easy to use. Generally they require no medical intervention or supervision. In addition, spermicides may kill or inhibit the growth of organisms responsible for sexually transmitted diseases. Disadvantages of spermicides are that they are generally less effective than many other methods, some interfere with sexual spontaneity, they may cause local irritations, and some women find them messy to use. Recently, concerns were expressed about the possible teratogenic effects of sperimicides. Most of these concerns proved to be unfounded. Given the many new avenues of research, the major disadvantage of sperimicides, i.e., their high failure rates, may be minimized in the near future. PMID:12340621

  10. Contraceptive use in Canada, 1984.

    PubMed

    Balakrishnan, T R; Krotki, K; Lapierre-Adamcyk, E

    1985-01-01

    Canada's first national fertility survey, carried out by telephone in 1984, found that 68 percent of all women aged 18-49-73 percent of currently married women, 69 percent of the previously married women and 57 percent of single women--are practicing contraception. Overall, the most widely used method of birth control in Canada is sterilization (male and female), which is relied on by almost 60 percent of all married users and 66 percent of previously married users. Among single women, the preferred method is the pill, chosen by seven out of 10 of such users. Among all women, the major determinant of method choice is age: The pill is overwhelmingly chosen by women under 25, and sterilization, by those 30 and over. While the IUD and the condom are used by roughly 10-14 percent of women in their 20s who practice contraception, these methods decline in importance with increasing age. Highly educated women are less likely than those with little education to elect sterilization, and more likely to rely on barrier methods. Differences in contraceptive prevalence and patterns of use between Catholics and Protestants have all but disappeared in Canada, but church attendance and country of birth appear to exert a modest influence on method choice. As might be anticipated, women whose family size is complete have considerably higher levels of contraceptive use than those who expect to have more children. The survey reveals no difference in contraceptive use between Quebec women and those in the rest of Canada, thus confirming both the accuracy of earlier Quebec studies showing extremely high levels of sterilization and the applicability of these findings to all other Canadian women.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3842662

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

    PubMed Central

    Roth, H. Daniel

    2015-01-01

    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

  12. Contraceptive choice and patient compliance. The health care provider's challenge.

    PubMed

    Branden, P S

    1998-01-01

    Contraceptive compliance is a multifaceted issue that is influenced by many factors. These factors can directly affect the level of patient compliance, thereby affecting contraceptive method efficacy rates. A review of the literature reveals many studies about contraceptive compliance but a dearth of studies addressing how to change noncompliant behaviors. This article describes the contraceptive methods currently available and their efficacy rates. Patient characteristics and the components of compliance are described as they affect contraceptive efficacy and patient care. Suggestions are made for the use of alternative terminology to include adherence to or continuance of a contraceptive method. Health care providers should realize the impact they can have on a patient's education, decision-making process, and ultimate compliance with a contraceptive method. It is the patient, however, who ultimately makes the decision, either actively or passively, to comply or not and whether to have an unplanned pregnancy. PMID:9871380

  13. Attitude toward contraception and abortion among Curaao women. Ineffective contraception due to limited sexual education?

    PubMed Central

    2011-01-01

    Background In Curaao is a high incidence of unintended pregnancies and induced abortions. Most of the induced abortions in Curaao are on request of the woman and performed by general practitioners. In Curaao, 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 Curaao 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

  14. Permanent Contraception for Women.

    PubMed

    Patil, Eva; Jensen, Jeffrey T

    2016-05-01

    Permanent contraception is a highly desired and commonly used contraceptive option for women around the world who desire never to become pregnant. Current methods of female permanent contraception require surgery. Postpartum tubal ligation and interval surgical tubal ligation are safe and effective, do not interfere with menstrual cycles, and require no ongoing cost or medical checkups. Hysteroscopic tubal occlusion offers a less invasive surgical approach, but requires an imaging study for verification of correct placement. However, not all women have access to a surgeon trained to provide permanent contraception, or they may face other prohibitive logistic or financial burdens. The development of novel permanent contraception methods that are immediately effective and/or nonsurgical could help improve access to and acceptability of permanent contraception. The expansion of permanent contraception options could help women achieve their family planning goals and reduce unintended pregnancies. PMID:26960907

  15. How a Married Woman`s Characteristics Affect her Contraceptive Behavior?

    NASA Astrophysics Data System (ADS)

    Khan, Rana Ejaz Ali; Khan, Tasnim

    In Pakistan, population growth rate is 2.2% and Total Fertility Rate (TFR) is as high as 5.4. It is the result of low Contraceptive Prevalence Rate (CPR) of only 28%. Due to low CPR, women have high rate of unwanted births in Pakistan. In this study using probit estimation on primary data, we have analyzed the woman=s characteristics responsible for low contraceptive prevalence among married women in urban areas of Punjab (Pakistan). For the purpose one thousand married women in the age group of 15-49 years, who were not currently pregnant were interviewed from urban areas of Bahawalpur and Lahore. The individual characteristics of married women were focused, although household characteristics, socio-economic conditions of the community where woman is living, religious and cultural factors are also important. It is found that age of woman, education of woman, woman`s status, her economic activity, income level and age at marriage were found major determinants of contraceptive prevalence in women. The policies towards the education of women, status of women, labor force participation of women and legal interventions towards the increase in marriage age are stressed to increase the CPR.

  16. [Discontinuation of contraception].

    PubMed

    Figueroa Perea, J G; Aparicio Jimenez, R C

    1991-01-01

    Institutional studies and demographic surveys have demonstrated that side effects or fear of side effects are by far the most important factor in discontinuation of usage of modern contraceptives. The most recent information in Mexico, from the 1987 National Survey of Fertility and Health, indicates that 15-24% of women who accepted IUDs, oral contraceptives (OCs), and injectable contraceptives reported discontinuing usage during the 1st year because of real or feared side effects. Discontinuance because of side effects is much less frequent with traditional methods, but such methods have much higher failure rates than do the modern methods. The reasons given for discontinuing use given by women in surveys correspond to their perceptions. Side effects thus include fears of possible future effects and effects attributed by users to the methods but which are not actually related, as well as real effects of varying severity and importance. In a recent survey, 2/3 of women who experienced contraceptive side effects were not aware of the possibility that they would arise at the time they began use of the method. This finding indicates that information services are lacking for the temporary methods promoted by institutional family planning programs. In case of female sterilization the couple is not able to terminate method use. It would be expected that a careful and fully informed decision process would precede acceptance of sterilization. But 1 out of 10 sterilized women interviewed for the survey stated they would not undergo sterilization again if they were able to choose. The women most likely to state they would not repeat sterilization were the ones who received the least information prior to operation, experienced a deficient acceptance process, received the least medical follow-up, and waited the shortest time between the sterilization decision and the actual operation. Such problems are more common among less educated and rural women. A basic condition for assuring that childbearing decisions are free and responsible is access to complete and accurate information. The reports of these women indicate that this condition is not being met. PMID:12158038

  17. Contraceptive use in China.

    PubMed

    Perkin, G W; Genstein, J; Morrow, M

    1980-01-01

    An estimate is made of the relative use of the various contraceptive methods--IUDs, sterilization, oral contraceptives (OCs), condoms, injectable contraceptives, abortion, and other contraceptive products approved for general use but only available in limited supply--in China at this time. All of the major contraceptive methods are available without cost. The user is permitted to be absent from work with pay when he/she chooses either IUD insertion/removal, vasectomy, tubal ligation, and induced abortion. IUDs, OCs, sterilization, and condoms account for most of the contraceptive practice in China. Abortion is also available, particularly as a backup to failed contraception. A look at the family planning program in the major municipal area of Tianjin provides an indication of the impact of the national planned birth program. In Tianjin, contraceptives are distributed without cost through the union representative or in the commune. Many men and women obtain their contraceptive supplies at work. The Tianjin program of social and economic incentives and disincentives is typical of such programs throughout China, but the specific details vary from province to province. There are many advantages to having the "only-child certificates" issued by the Tianjin Municipal Revolutionary Council. Economic sanctions are recommended for couples who have a 2nd child. The IUD is the most widely used method in China and is the method most often recommended for women living in rural areas. The IUD may account for as much as 50% of national contraceptive practice. The most widely used IUD consists of a single ring of tightly coiled stainless steel wire. Male and female sterilization is available in most parts of China and accounts for about 30% of contraceptive practice. OC use may be estimated to account for about 8-10% of national contraceptive practice. The condom accounts for about 6% of national contraceptive practice and the injectable for about 1% of total contraceptive use. PMID:12311625

  18. [Recent changes in contraceptive use and fertility in Korea].

    PubMed

    Cho, N H; Kong, S K; Lim, J K

    1984-12-01

    In order to achieve planned demographic targets set for the period 1982-86, the government announced a new comprehensive population control policy in December 1981. This new set of policies calls for: 1) improving the current operation and management systems of the national family planning program; 2) strengthening the innovative social support policies including the incentive and disincentive schemes which encourage the small family; 3) integrating the family planning programs with other developed programs; and 4) establishing an end to these programs. As a result of government efforts to set up population measures, the number of those undergoing sterilization with 2 or fewer children and the contraceptive acceptance rate have increased greatly since 1982. The contraceptive practice rate for those ages 15-44 went to 58% in 1982. The total fertility rate dipped from 2.7 births/woman in 1981 to 2.4 in 1983. However, regional differentials in fertility rates are clearly observed. The urban fertility rate is lower than the rural and the regional differentials in fertility seem to derive from the strong son preference which is quite prevalent in the rural sector. The increase in contraceptive practice rate has contributed to the improvement of maternal health by preventing induced abortion. Since the inception of the family planning slogan focusing on the 1-child family, the proportion of respondents who said 1 child was enough rose from 16% in 1982 to 65% in 1984. With appropriate incentives, this figure is likely to increase. What remains is to lower the fertility rate for those in the 20-29 age group who currently account for over 80% of the total annual births. The current program management systems must recruit new acceptors among the younger age groups and must persuade them to resort to temporary contraceptive methods for birth spacing. The social support policies must be strengthened by providing preferential treatment for those with only 1 child and eliminating the son preference. The commercial sector programs must also be strengthened by providing preferential treatment to the contraceptive manufacturing companies and by providing educational programs for private physicians and pharmacists. Among the future directions mentioned above, Korea's foremost population control policy should address the eradication of son preference by instituting bold socal support policies including incentive systems for the 1 child family. (author's modified) PMID:12313503

  19. Determinants of Contraceptives Use amongst Youth: An Exploratory Study with Family Planning Service Providers in Karachi Pakistan

    PubMed Central

    Nishtar, Noureen Aleem; Sami, Neelofar; Alim, Sabina; Pradhan, Nousheen; Farid-Ul-Hasnain

    2013-01-01

    Introduction: In Pakistan, Contraceptive Prevalence Rate (CPR) among married female youth is 17.4% and even lower in rural and slum areas leading to rapid population growth on one hand and poor health consequences on the other. The study was conducted to explore family planning service providers’ perceptions regarding use of different contraceptive methods and to identify factors that are influencing their use amongst currently married youth aged 18-24 years in slum areas of Karachi. Method: Qualitative exploratory study design was adopted and a total of ten in-depth interviews were conducted with family planning service providers of the area. For content analysis coding of transcribed interviews was done and then categories were made and furthermore themes were derived. Results: Our findings revealed that family planning service providers perceived that there is low use of contraceptive methods amongst youth of study area and low usage could be due to side effects; myths and misconceptions; lack of proper knowledge about different contraceptives; unmet needs of contraceptives; socio-cultural and religious factors about different contraceptive methods and family planning service providers own biases against or for use of contraceptive methods amongst youth in the study area. However better education of youth and family planning service providers’ improved knowledge about counseling and use of contraceptive methods was perceived to be associated with improved use of family planning methods amongst youth of the study area. Conclusion: Exaggerated side effects and socio-cultural factors could be important influences leading to low use of family planning methods amongst youth of Karachi. Some policy initiatives are the training of lady health Workers, lady health visitors, physicians and staff of the pharmacies for counseling youth in the correct use of family planning methods. PMID:23618469

  20. Reproductive health during adolescence: AIDS/STD and contraception.

    PubMed

    1987-02-01

    Sex education and more widespread use of modern contraceptives are urgent needs in view of alarming increases in the rate of adolescent pregnancy, induced abortion, and sexually transmitted diseases (STDs). Chlamydia trachomatis and nongonococcal urethritis are the most common STDs in both developed and developing countries. Other STDs that are prevalent among adolescents are herpes and gonococcal urethritis. The "hitch-hiking" phenomenon of microbes on sperm surfaces is of special clinical significance in STDs. Bacteria, fungi, and viruses hitch-hiking on the surfaces of spermatozoa adhere to surface epithelium of the female reproductive tract and are transported to the fallopian tubes and peritoneal cavity. Protective behavior such as condom usage is highly needed for sexual partners who may be carrying the acquired immunodeficiency syndrome (AIDS) virus. The risk of transmitting the AIDS virus increases with multiple sexual partners and multiple infections with other STDs. The AIDS virus, attached to the plasmalemma of spermatozoa, is transmitted to the egg during the process of fertilization. International cooperation in research in contraception for adolescents is urgently needed to allow for the transfer of skills to the Third World and the early testing of new or improved contraceptives under conditions of use in developing countries. PMID:12314751

  1. Update on contraception.

    PubMed

    Wilkinson, C L; Stirland, A M; Massil, H

    1997-04-01

    Genitourinary medicine (GUM) clinics are likely to play an expanded role in the provision of family planning services. A recent survey of GUM clinics in the UK indicated that 71.4% provided emergency contraception and 48.1% provided routine contraception services. To facilitate the ability of GUM practitioners to provide contraceptive counseling and supplies to both men and women, this article reviews the current state of emergency contraception, combined oral contraceptives (OCs), modern IUDs, the levonorgestrel-releasing intrauterine system, female condoms, and the personalized computerized contraceptive system Persona. Also reviewed are current issues regarding the possible impact of combined OCs on an increased risk of venous thromboembolism and breast cancer. PMID:9147153

  2. Contraception use and unplanned pregnancies among injection drug using women in St Petersburg, Russia

    PubMed Central

    Abdala, Nadia; Kershaw, Trace; Krasnoselskikh, Tatiana V; Kozlov, Andrei P

    2013-01-01

    Background This cross-sectional study estimated the prevalence of contraceptive methods and investigated whether abortion rates influence contraceptive behaviour among injection drug-using (IDU) women in St Petersburg, Russia. Methodology A self-administered questionnaire of behaviour in the last 3 months was applied to a convenient sample of IDU women. Results Of 80 sexually active participants, 67% had had an abortion. No participant reported using hormonal contraceptives or intrauterine devices (IUDs). The only valid method of contraception used was condoms, which was reported by half of the participants. Consistent condom use was reported by 22% of participants and was no more likely among those who had an abortion. Condom use was significantly associated with having multiple or casual sex partners [prevalence ratio (PR) 1.75, 95% (confidence interval) CI 1.11–2.78, p = 0.01], having an IDU sex partner (PR 0.55, 95% CI 0.36–0.85, p = 0.029) and with a negative attitude toward condoms (PR 0.53, 95% CI 0.33–0.84, p = 0.01). Abortions were less likely among those who had multiple or casual sex partners (PR 0.69, 95% CI 0.49–0.97, p = 0.03). Conclusions Despite the high prevalence of abortions among IDU women, none reported the use of hormonal contraception or IUDs. Having had an abortion was not associated with greater likelihood of using condoms. Participants mostly used condoms with casual or multiple sex partners, suggesting that condoms were used mainly to prevent HIV/sexually transmitted infection transmission and not to prevent pregnancy. Programmes to prevent unwanted pregnancies and reduce abortion-related health risks among this understudied vulnerable group are needed. PMID:21493618

  3. Neighborhood Incarceration Rate and Asthma Prevalence in New York City: A Multilevel Approach

    PubMed Central

    Hong, Clemens S.; Subramanian, S. V.; Wang, Emily A.

    2013-01-01

    Objectives. We examined the association between neighborhood incarceration rate and asthma prevalence and morbidity among New York City adults. Methods. We used multilevel modeling techniques and data from the New York City Community Health Survey (2004) to analyze the association between neighborhood incarceration rate and asthma prevalence, adjusting for individual-level sociodemographic, behavioral, and environmental characteristics. We examined interactions between neighborhood incarceration rate, respondent incarceration history, and race/ethnicity. Results. The mean neighborhood rate of incarceration was 5.4% (range = 2.1%–12.8%). Neighborhood incarceration rate was associated with individual-level asthma prevalence (odds ratio [OR] = 1.06; 95% confidence interval [CI] = 1.03, 1.10) in unadjusted models but not after adjustment for sociodemographic characteristics (OR = 1.01; 95% CI = 0.98, 1.04). This association did not differ according to respondent race/ethnicity. Conclusions. Among New York City adults, the association between neighborhood incarceration rate and asthma prevalence is explained by the sociodemographic composition of neighborhoods and disparities in asthma prevalence at the individual level. Public health practitioners should further engage with criminal justice professionals and correctional health care providers to target asthma outreach efforts toward both correctional facilities and neighborhoods with high rates of incarceration. PMID:23488496

  4. Oral Contraceptive Pill and PCOS

    MedlinePlus

    ... Health Gynecology Medical Conditions Nutrition & Fitness Emotional Health PCOS: The Oral Contraceptive Pill Posted under Health Guides . ... of oral contraceptive pills for young women with PCOS? Regular and Lighter Periods: Oral contraceptive pills can ...

  5. Irish Bill on contraception.

    PubMed

    1979-01-01

    The Irish Minister of Health has introduced a Bill on family planning to the Irish Parliament which would 1) require prescriptions for contraceptive distribution, 2) limit distribution to pharmacies, 3) restrict the provision of contraceptive advice to licensed centers, 4) require that these centers distribute information on "natural" methods of family planning, 5) establish clinics to advise on rhythm methods, 6) allow physicians to prescribe contraceptives only for married persons or for adequate medical reasons, 7) require importers or manufacturers to seek a license, 8) prohibit the advertisement or display of contraceptives, 9) prohibit abortions and the import, sale, or manufacture of abortifacients, 10) allow physicians or pharmacists to refuse to provide contraceptives against their conscience, and 11) include penalties of stiff fines or imprisonment up to 12 months for infringement. Following the 1973 Irish Supreme Court decision that the prohibition of contraceptive importation was unconstitutional, a family planning Bill was inevitable. This Bill may also be proved unconstitutional if it becomes law. The Bill does not remedy potential geographic deficiencies in contraceptive service created by the conscience clause and it does not require proper training on the part of the physicians who will prescribe contraceptives. If it becomes law, Ireland will have the most repressive contraceptive legislation in Europe. PMID:12178340

  6. 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

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

    1992-04-01

    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

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

    PubMed Central

    Hassan, Che Hashim

    2013-01-01

    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

  8. Communication about contraception and knowledge of oral contraceptives amongst Norwegian high school students.

    PubMed

    Hansen, Thomas; Skjeldestad, Finn Egil

    2003-08-01

    Communication about contraception and specific knowledge of oral contraceptives (OCs) were examined in a sample (n = 4,650) of Norwegian high school students. Data were collected through a 44-item questionnaire especially developed for the study. The response rate was 73% and data from a total of 1,714 girls and 1,389 boys were eligible for analyses. More females (83%) than males (54%) discussed contraception at least monthly. Discussions were predominantly held with peers and not adults. Females were far more knowledgeable about OCs than males. Respondents knew more about side effects and the pill's relative efficacy than about risks of cancer and tromboembolism. The most significant predictors of high knowledge scores were gender and OC use (females). Also predictive of high knowledge scores were frequent discussions about contraception with peers. Talks about contraception with health workers were unrelated to knowledge scores. PMID:12887936

  9. Contraception Use, Abortions, and Births: The Effect of Insurance Mandates.

    PubMed

    Mulligan, Karen

    2015-08-01

    Beginning August, 2012, the U.S. Patient Protection and Affordable Care Act (ACA) required new private health insurance plans to cover contraceptive methods and counseling without requiring an insured's copay. The ACA represents the first instance of federally mandated contraception insurance coverage, but 30 U.S. states had already mandated contraceptive insurance coverage through state-level legislation prior to the ACA. This study examines whether mandated insurance coverage of contraception affects contraception use, abortions, and births. I find that mandates increase the likelihood of contraception use by 2.1 percentage points, decrease the abortion rate by 3 %, and have an insignificant impact on the birth rate. The results imply a lower-bound estimate that the ACA will result in approximately 25,000 fewer abortions. PMID:26153735

  10. Male Adolescent Contraceptive Utilization.

    ERIC Educational Resources Information Center

    Finkel, Madelon Lubin; Finkel, David J.

    1978-01-01

    The contraceptive utilization of a sample of sexually active, urban, high school males (Black, Hispanic, and White) was examined by anonymous questionnaire. Contraceptive use was haphazard, but White males tended to be more effective contraceptors than the other two groups. Reasons for nonuse were also studied. (Author/SJL)

  11. Migraine and oral contraceptives.

    PubMed

    Mousa, G Y

    1982-10-01

    Migraine is a common complaint in optometric practice. Three cases of migrainous patients taking oral contraceptives are presented in this report. The role of oral contraceptives in triggering a migraine attack and possibly elevating the risk of a stroke in a patient with migraine is discussed. The counseling an optometrist can provide in such cases in discussed. PMID:7148975

  12. [Contraception among adolescents].

    PubMed

    Porozhanova, V; Tanchev, S; Goranov, M

    1994-01-01

    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

  13. Contraception and women's health.

    PubMed

    Fathalla, M F

    1993-01-01

    More and more women all over the world are opting for fertility by choice not by chance. Contraceptive use has a tremendous impact on women's health. The ability to regulate and control fertility is a basic component of health, positively defined as a state of physical, mental and social well-being. Contraception is saving the lives of women around the world from the hazards of unwanted pregnancy. Optimal childbearing is also contributing to infant and child survival. Contraception has a complex relationship to sexually-transmitted diseases. Contraceptive safety is a major public health concern. The risk/benefit assessment will differ for different populations, for different individuals, and even for the same individual at different periods of life. The family planning movement started as a movement by women for women. Women's perspectives and women's concerns should guide the future of contraceptive research and development. PMID:8324613

  14. Urgent need for contraceptive education and services in Chinese unmarried undergraduates: a multi-campus survey.

    PubMed

    Zhou, Yuanzhong; Xiong, Jinwen; Li, Jie; Huang, Shiyun; Shang, Xuejun; Liu, Guohui; Zhang, Meimei; Yin, Pin; Wei, Sheng; Xiong, Chengliang

    2011-08-01

    In order to ascertain prevalence rate of premarital sexual intercourse, unintended pregnancy and abortion, and evaluate associated factors of unintended pregnancy among undergraduates from all over China, the representative sample of unmarried undergraduates was obtained by using a multi-stage, stratified, probability cluster design, and data were collected by using a survey questionnaire. 62 326 available responders were gained. 11.6% of them acknowledged having experiences of premarital sexual intercourse (standardized prevalence rate of sexual intercourse was 13.8%). 31.5% of students active in premarital sex acknowledged undergoing unintended pregnancy. 76.2% of pregnant students selected abortion to end it. Of students active in premarital sex, 46.2% used contraception at the first sexual intercourse, 28.2% replied "always" using contraception in sexual intercourse. The rate of using condoms, oral contraceptives (OCs), and withdrawal among students who had used contraception was 52.0%, 31.0%, and 27.2% respectively. "No preparation for sex" (40.3%), "pleasure decrement" (32.1%), "won't-be-pregnancy in occasional sexual intercourse" (30.2%) were their common excuses for using no contraception. The identified risk factors for unintended pregnancy among students active in premarital sex by multivariate analysis were as follows: having no steady lover [having no steady lover vs having a steady lover: odds ratio (OR), 1.875; 95% confidence interval (CI), 1.629-2.158], unaware of the course of conception (unaware vs aware: OR, 2.023; 95% CI, 1.811-2.260), considering abortion not endanger women's physical and mental health (no endangerment vs endangerment: OR, 2.659; 95% CI, 2.265-3.121), nonuse of contraception (never use vs always use: OR, 1.682; 95% CI, 1.295-2.185). Medical students were not less likely to experience an unintended pregnancy than nonmedical students (OR, 1.111; 95% CI, 0.906-1.287). The substantial proportion of unintended pregnancy among undergraduates indicates a need for convenient and targeted contraceptive education and services. PMID:21823000

  15. Contraceptive efficacy of a monophasic oral contraceptive containing desogestrel.

    PubMed

    Corson, S L

    1993-03-01

    Desogestrel, a new gonane progestin, has been shown to be comparable in efficacy with oral contraceptives currently in use in the United States. Results from several large efficacy studies conducted in Europe encompassing 42,640 patients in 183,212 cycles resulted in six pregnancies for a Pearl index of 0.04. This low rate, which was compared with those observed in recent U.S. clinical trials, reflects differences in study methodology. An additional indicator of an oral contraceptive's efficacy is its ability to suppress ovarian function, including follicular development and increases in plasma estradiol levels. Desogestrel has been found to be among the strongest suppressors of ovarian activity. PMID:8447354

  16. Changes in Contraceptive Use in Bulgaria, 1995-2000

    PubMed Central

    Carlson, Elwood; Lamb, Vicki

    2009-01-01

    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

  17. Recent advances in hormonal contraception

    PubMed Central

    Li, HW Raymond

    2010-01-01

    This report reviews some of the new studies regarding new hormonal contraceptive formulations (e.g., Yaz, Qlaira®, extended-cycle or continuous combined contraceptives, subcutaneous depot medroxyprogesterone acetate, and ulipristal acetate as an emergency contraceptive). Recent data on the relationship between hormonal contraceptive use and bone health are also reviewed. PMID:21173872

  18. The 1998 Canadian Contraception Study.

    ERIC Educational Resources Information Center

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

    1999-01-01

    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…

  19. Contraceptive use in women with hypertension and diabetes: cross-sectional study in northwest Ethiopia

    PubMed Central

    Mekonnen, Tensae Tadesse; Woldeyohannes, Solomon Meseret; Yigzaw, Tegbar

    2015-01-01

    Purpose Women with diabetes and hypertension are at increased risk of pregnancy complications, including those from surgical delivery and their offspring are at risk for congenital anomalies. Thus, diabetic and hypertensive women of reproductive age are advised to use valid contraceptive methods for reducing unwanted pregnancy and its complications. However, contraceptive use among these segments of the population had not been previously assessed in Ethiopia. Hence, the aim of this study was to assess contraceptive use and associated factors among diabetic and hypertensive women of reproductive age on chronic follow-up care at University of Gondar and Felege Hiwot Hospitals. Methods Hospital-based cross-sectional study was conducted from April to May 2012 among diabetic and hypertensive women on follow-up at the chronic illness care center. The sample size calculated was 403. Structured and pretested questionnaire was used for data collection. Data were collected using interview supplemented by chart review. The data were entered using EPI info Version 2000 and analyzed using SPSS Version 16. Frequencies, proportion, and summary statistics were used to describe the study population in relation to relevant variables. Both bivariate and multivariate analyses were run to see the association of each independent variable with contraceptive practice. Results A total of 392 married women on chronic follow-up care were interviewed making the response rate of 93.3%. The contraceptive prevalence rate was found to be 53.8%. Factors such as age 25–34 years (adjusted odds ratio, AOR [95% confidence interval, CI] =3.60 [1.05–12.36]), (AOR [95% CI] =2.29 [1.15–4.53]), having middle- and high-level incomes (AOR [95% CI] =2.12 [1.19–3.77]), (AOR [95% CI] =5.03 [2.19–11.54]), receiving provider counseling (AOR [95% CI] =9.02 [4.40–18.49]), and controlled disease condition (AOR [95% CI] =4.13 [2.35–7.28]) were significantly associated with contraceptive practice. Conclusion The contraceptive utilization of women on diabetes and hypertension follow-up care was found to be low. Hence, strengthening counseling and education about family planning and controlling their medical conditions would help increase the contraceptive uptake of women on chronic follow-up. PMID:26715862

  20. Depression and anxiety in ovarian cancer: a systematic review and meta-analysis of prevalence rates

    PubMed Central

    Watts, Sam; Prescott, Philip; Mason, Jessica; McLeod, Natalie; Lewith, George

    2015-01-01

    Objectives To systematically review the literature pertaining to the prevalence of depression and anxiety in patients with ovarian cancer as a function of treatment stage. Design Systematic review and meta-analysis. Participants 3623 patients with ovarian cancer from primary research investigations. Primary outcome measure The prevalence of depression and anxiety in patients with ovarian cancer as a function of treatment stage. Results We identified 24 full journal articles that met the inclusion criteria for entry into the meta-analysis resulting in a pooled sample size of 3623 patients. The meta-analysis of prevalence rates identified pretreatment, on-treatment and post-treatment depression prevalences of 25.34% (CI 22.79% to 28.07%), 22.99% (CI 19.85% to 26.46%) and 12.71% (CI 10.14% to 15.79%), respectively. Pretreatment, on-treatment and post-treatment anxiety prevalences were 19.12% (CI 17.11% to 21.30%), 26.23% (CI 22.30% to 30.56%) and 27.09% (CI 23.10% to 31.49%). Conclusions Our findings suggest that the prevalence of depression and anxiety in women with ovarian cancer, across the treatment spectrum, is significantly greater than in the healthy female population. With the growing emphasis on improving the management of survivorship and quality of life, we conclude that further research is warranted to ensure psychological distress in ovarian cancer is not underdiagnosed and undertreated. PMID:26621509

  1. The future of hormonal contraception.

    PubMed

    Potts, D M; Smith, J B

    1991-01-01

    Well over 100,000,000 women have used the combined oral contraceptive (OC) pill. As a result of the population explosion in the 1970s and 1980s, there will be almost one third more women in fertile age in the year 2000 than in 1991. In the developing world outside China, the total number of contraceptive users could double in roughly 10 years. China, the total number of contraceptive users could double in roughly 10 years. The pill has a low failure rate, but one study in Egypt found that 90% of women made errors in moving from one packet to the next. Similarly, a 60% error rate was found among users in Colombia. The vaginal ring delivers combined progestogen and estrogen through a silastic wall. The device can be left in place for 21 days out of 28, and such delivery would virtually eliminate the low risk of hepatocellular carcinoma among OC users. A vaginal progestogen ring is being tested. Over 700,000 women have used Norplant, the subdermal implant method with an effectiveness rate of 99%. Depo-provera and norethindrone enanthate injections last 2 to 3 months. The Progestasert IUD, containing 38 mg progesterone released at a rate of 65 mcg per day, is effective. Progesterone-releasing IUDs lasting from 3 to 5 years could complement subdermal implants. Ethinyl estradiol (205 mg) and diethylstilbestrol (25-50 mg) have both been used as postcoital agents taken within 36 hours for 5 consecutive days after unprotected intercourse. In more than 3000 cases there were 17 pregnancies (.05%). These regimens are replaced by giving combined oral contraceptive tables (e.g., .25 mg d-norgestrel and 50 mg ethinyl estradiol), taken 2 at a time and repeated 12 hours later, within 72 hours of unprotected intercourse. Epidemiological studies have confirmed that the use of the combined oral contraceptive for 3 to 5 years halves a woman's risk of ovarian or endometrial cancer, and the protection persists for 10 to 18 years after cessation of use. PMID:1687405

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

    ERIC Educational Resources Information Center

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

    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…

  3. Perceived Prevalence of Teasing and Bullying Predicts High School Dropout Rates

    ERIC Educational Resources Information Center

    Cornell, Dewey; Gregory, Anne; Huang, Francis; Fan, Xitao

    2013-01-01

    This prospective study of 276 Virginia public high schools found that the prevalence of teasing and bullying (PTB) as perceived by both 9th-grade students and teachers was predictive of dropout rates for this cohort 4 years later. Negative binomial regression indicated that one standard deviation increases in student- and teacher-reported PTB were…

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

    ERIC Educational Resources Information Center

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

    2006-01-01

    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…

  5. Perceived Prevalence of Teasing and Bullying Predicts High School Dropout Rates

    ERIC Educational Resources Information Center

    Cornell, Dewey; Gregory, Anne; Huang, Francis; Fan, Xitao

    2013-01-01

    This prospective study of 276 Virginia public high schools found that the prevalence of teasing and bullying (PTB) as perceived by both 9th-grade students and teachers was predictive of dropout rates for this cohort 4 years later. Negative binomial regression indicated that one standard deviation increases in student- and teacher-reported PTB were

  6. Prevalence rates of obsessive-compulsive symptoms and psychiatric comorbidity among adolescents in Iran.

    PubMed

    Shams, Giti; Foroughi, Elham; Esmaili, Yaghoob; Amini, Homayoon; Ebrahimkhani, Narges

    2011-01-01

    Recent epidemiological studies show that obsessive-compulsive disorder (OCD) and its comorbidity with psychiatric problems is more prevalent among children and adolescents than was previously believed. The primary aim of the current study is to investigate the point-prevalence rate of obsessive compulsive symptoms in a sample of adolescent high school student in Iran. A two-stage epidemiological study was carried out through a clustered random sampling method. All participants went through a two-stage assessment procedure, in the first screening phase, the Maudsley Obsessive-Compulsive Inventory (MOCI) was administered to 909 randomly selected students (in the age range 14-18 years). Participants were considered possible sub-clinical or clinical OCD cases, if they obtained a score of MOCI≥15. In the second stage, the Symptoms Checklist -90-revised (SCL-90-R) was administered to student who fulfilled the screening criteria. The prevalence of OC symptoms was found to be 11.2 percent for the total sample. The most prevalent comorbid conditions were depression and anxiety with prevalence rates of 91.2 and 78.4 percent respectively. Gender, age, birth-order, parent's education and family income had no statistically significant association with OC symptoms. Further research in this area is warranted in order to establish a set of comprehensive global assessment and measurement tools, which would allow cross-cultural studies in the field of OCD. PMID:22071645

  7. Out from behind the contraceptive Iron Curtain.

    PubMed

    Jacobson, J L

    1990-01-01

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

  8. Estimating the Prevalence and Awareness Rates of Hypertension in Africa: A Systematic Analysis

    PubMed Central

    Adeloye, Davies; Basquill, Catriona

    2014-01-01

    Background The burden of hypertension is high in Africa, and due to rapid population growth and ageing, the exact burden on the continent is still far from being known. We aimed to estimate the prevalence and awareness rates of hypertension in Africa based on the cut off “≥140/90 mm Hg”. Methods We conducted a systematic search of Medline, EMBASE and Global Health. Search date was set from January 1980 to December 2013. We included population-based studies on hypertension, conducted among people aged ≥15 years and providing numerical estimates on the prevalence of hypertension in Africa. Overall pooled prevalence of hypertension in mixed, rural and urban settings in Africa were estimated from reported crude prevalence rates. A meta-regression epidemiological modelling, using United Nations population demographics for the years 1990, 2000, 2010 and 2030, was applied to determine the prevalence rates and number of cases of hypertension in Africa separately for these four years. Results Our search returned 7680 publications, 92 of which met the selection criteria. The overall pooled prevalence of hypertension in Africa was 19.7% in 1990, 27.4% in 2000 and 30.8% in 2010, each with a pooled awareness rate (expressed as percentage of hypertensive cases) of 16.9%, 29.2% and 33.7%, respectively. From the modelling, over 54.6 million cases of hypertension were estimated in 1990, 92.3 million cases in 2000, 130.2 million cases in 2010, and a projected increase to 216.8 million cases of hypertension by 2030; each with an age-adjusted prevalence of 19.1% (13.9, 25.5), 24.3% (23.3, 31.6), 25.9% (23.5, 34.0), and 25.3% (24.3, 39.7), respectively. Conclusion Our findings suggest the prevalence of hypertension is increasing in Africa, and many hypertensive individuals are not aware of their condition. We hope this research will prompt appropriate policy response towards improving the awareness, control and overall management of hypertension in Africa. PMID:25090232

  9. Unintended Pregnancy Prevention: Contraception

    MedlinePlus

    ... Effectiveness of Contraceptive Methods [PDF - 670KB] . Effectiveness of Family Planning Methods (Poster Size, 2'x 3') Effectiveness of Family Planning Methods [PDF - 305KB] (in English) Eficacia de los ...

  10. Male hormonal contraceptives.

    PubMed

    Anawalt, B D; Amory, J K

    2001-09-01

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

  11. Promoting emergency contraception.

    PubMed

    Stewart, F

    1998-08-15

    The use of available oral contraceptive agents for emergency contraception has been judged safe and effective by the U. S. Food and Drug Administration and other agencies. Yet implementation by physicians has been limited, and only a small percentage of women take advantage of this option each year. Lack of a specially packaged--and marketed--product for this indication has been a major barrier. PMID:9717481

  12. Evaluative Indices Assigned to Contraceptive Methods by University Undergraduates

    ERIC Educational Resources Information Center

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

    2011-01-01

    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…

  13. Can early breastfeeding support increase the 6-8 week breastfeeding prevalence rate?

    PubMed

    Price, Linda

    2014-05-01

    Breastfeeding has significant health benefits for mothers and babies and is an important strategy to reduce health inequalities (UNICEF, 2010). The Baby Friendly Initiative, a strategy to increase breastfeeding rates, has been adopted by the trust. In line with the trust's priorities, the health visiting team initiated a project to increase the 6-8 breastfeeding prevalence rates. Breastfeeding mothers in a defined project area were offered breastfeeding support in their homes within the first postnatal week. Although the results after six months did demonstrate an overall increase in the 6-8 week prevalence rate of 5%, the monthly figures where disappointingly inconsistent and it was difficult to attribute the rise to the increased support offered. Nevertheless, the feedback from mothers who received support demonstrated that it was valued and had a positive impact on their confidence to continue to breastfeed. PMID:24881195

  14. National prevalence rates of bully victimization among students with disabilities in the United States.

    PubMed

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

    2012-12-01

    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 34.1% in middle school. This is one to one and a half times the national average for students without disabilities. The rate of bully victimization was highest for students with emotional disturbance across school levels. Findings from this study also indicated that students with disabilities who were bullied once were at high risk of being bullied repeatedly. Elementary and middle school students with autism and high school students with orthopedic impairments were at the greatest risk of experiencing repeated victimization. Implications of the findings are discussed. PMID:23294235

  15. Survey on the use of health services by adult men: prevalence rates and associated factors.

    PubMed

    Arruda, Guilherme Oliveira de; Marcon, Sonia Silva

    2016-01-01

    Objective estimate the prevalence and identify factors associated with the use of health services by men between 20 and 59 years of age. Method population-based, cross-sectional domestic survey undertaken with 421 adult men, selected through systematic random sampling. The data were collected through a structured instrument and analyzed using descriptive and inferential statistics with multiple logistic regression. Results the prevalence rate of health service use during the three months before the interviews was 42.8%, being higher among unemployed men with a religious creed who used private hospitals more frequently, had been hospitalized in the previous 12 months and referred some disease. Conclusion the prevalence of health service use by adult men does not differ from other studies and was considered high. It shows to be related with the need for curative care, based on the associated factors found. PMID:27027680

  16. Survey on the use of health services by adult men: prevalence rates and associated factors1

    PubMed Central

    de Arruda, Guilherme Oliveira; Marcon, Sonia Silva

    2016-01-01

    Objective estimate the prevalence and identify factors associated with the use of health services by men between 20 and 59 years of age. Method population-based, cross-sectional domestic survey undertaken with 421 adult men, selected through systematic random sampling. The data were collected through a structured instrument and analyzed using descriptive and inferential statistics with multiple logistic regression. Results the prevalence rate of health service use during the three months before the interviews was 42.8%, being higher among unemployed men with a religious creed who used private hospitals more frequently, had been hospitalized in the previous 12 months and referred some disease. Conclusion the prevalence of health service use by adult men does not differ from other studies and was considered high. It shows to be related with the need for curative care, based on the associated factors found. PMID:27027680

  17. History of oral contraception.

    PubMed

    Dhont, Marc

    2010-12-01

    On the 50th birthday of the pill, it is appropriate to recall the milestones which have led to its development and evolution during the last five decades. The main contraceptive effect of the pill being inhibition of ovulation, it may be called a small miracle that this drug was developed long before the complex regulation of ovulation and the menstrual cycle was elucidated. Another stumbling block on its way was the hostile climate with regard to contraception that prevailed at the time. Animal experiments on the effect of sex steroids on ovulation, and the synthesis of sex steroids and orally active analogues were the necessary preliminaries. We owe the development of oral contraceptives to a handful of persons: two determined feminists, Margaret Sanger and Katherine McCormick; a biologist, Gregory Pincus; and a gynaecologist, John Rock. Soon after the introduction of the first pills, some nasty and life-threatening side effects emerged, which were due to the high doses of sex steroids. This led to the development of new preparations with reduced oestrogen content, progestins with more specific action, and alternative administration routes. Almost every decade we have witnessed a breakthrough in oral contraception. Social and moral objections to birth control have gradually disappeared and, notwithstanding some pill scares, oral contraceptives are now one of the most used methods of contraception. Finally, all's well that ends well: recent reports have substantiated the multiple noncontraceptive health benefits paving the way for a bright future for this 50-year-old product. PMID:21091163

  18. A Lower-Cost Option for Intrauterine Contraception.

    PubMed

    Angelini, Kim

    2016-01-01

    In March 2015, the U.S. Food and Drug Administration approved Liletta (Actavis, Dublin, Ireland), a new intrauterine device for contraception. The Centers for Disease Control and Prevention recommend use of long-acting reversible contraception (LARC) as first-line pregnancy prevention. LARC efficacy rates are similar to those of sterilization, with the possibility for quick return of fertility upon removal of the device. Despite benefits and recommendations for this form of contraception, access and high cost remain barriers to use. Liletta is the first lower-cost option for intrauterine contraception. Available to qualified clinics and health centers at a reduced rate, this device may increase availability and decrease the overall cost to women who desire intrauterine contraception. PMID:27067935

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

    PubMed Central

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

    2014-01-01

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

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

    ERIC Educational Resources Information Center

    Alise, Mark A.; Teddlie, Charles

    2010-01-01

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

  1. Introducing new contraceptives.

    PubMed

    Segal, S J; Coutinho, E

    1986-12-01

    At this time, private research efforts to discover new contraceptives are threatened. Drug companies, particularly in the US, have reduced their interest in contraceptive development due to concern over the rising cost of product liability insurance, the cost of lawsuits in defense of liability claims, and the fear of extremely high awards by juries in product liability cases. The current form of private-public collaboration, now threatened by the liability crisis, works under a few simple principles of agreement. Private industry agrees to supply its patented chemical compounds for assessment as contraceptive agents, to be willing to enter into negotiations with public sector organizations to develop the contraceptive drugs if initial tests warrant it, and to release compounds to another company if the patent-holder declines to proceed with contraceptive development. The public-sector program agrees to fund the studies, keep the industry informed, and maintain confidentiality. When the technology is discovered by the public sector and is of potential interest to private industry, the collaboration involves other issues. The public agency agrees to supply manufacturing know-how and all biological and clinical information, to license under applicable patents, and to permit cross reference to regulatory agency filings. Private industry agrees to use its best efforts to bring the product to market, to manufacture the product at reduced cost for public sector use, or to provide know-how for others to do so. It also agrees to assume product liability and to grant the public sector agency licenses to any patented improvement in its product. Contraceptive research both within and outside the US is feeling the effects of the US litigious atmosphere. Companies from abroad now wish to steer clear of contraceptive research, even though these companies would be prepared to meet the requirements of the Food and Drug Administration. Contraceptives, considered to be high risk targets for lawsuits, are receiving little of the research budgets of pharmaceutical companies. Opposition anti-abortion forces also has had an effect. When the Population Council received new drug approval for the Copper-T-200, it was the 1st time the FDA had issued approval to a noncommercial sponsor. This unprecedented event established a new phase in the cooperative efforts between industry and the nonprofit sector to develop contraceptive products. It showed that given adequate funding, nonprofit agencies can carry out full product development, including the initial regulatory agency clearances. PMID:12341234

  2. Recent advances in contraception

    PubMed Central

    Trussell, James

    2014-01-01

    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

  3. Emergency contraception: a review.

    PubMed

    Corbelli, J; Bimla Schwarz, E

    2014-12-01

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

  4. Labeling emergency contraception.

    PubMed

    1994-12-01

    According to the signers of a November 28 citizens' petition filed with the Food and Drug Administration (FDA), unintended pregnancies and abortions could be reduced significantly if the FDA would require the relabeling of several oral contraceptives as emergency or postcoital contraception, also known as "morning after pills." It has long been established that within 72 hours after unprotected intercourse or contraceptive failure, a specified combination of pills taken at specified intervals can reduce the risk of pregnancy by an estimated 75%. Although physicians at university health clinics, in hospital emergency rooms treating rape victims, and at some family planning clinics prescribe emergency contraceptives, other physicians are reluctant to do so without relabeling, and most women taking the pill do not know the correct dosage. Calling this a "critical public health issue," attorneys at the Center for Reproductive Law and Policy petitioned the FDA for a labeling change on the grounds that manufacturers are in fact "misbranding" pills by suppressing emergency contraceptive information. If pill makers rewrite their patient packet inserts, women undoubtedly would have far greater control over the occurrence of an unintended pregnancy, the attorneys said. PMID:12288098

  5. Contraceptive choice and acceptability: the future for STI risk in Kelantan, Malaysia.

    PubMed

    Shiely, Frances; Saifuddin, Mohammed Syafiek

    2014-03-01

    More than 150 million women become pregnant in developing countries annually and an estimated 287,000 die from pregnancy-related causes. Contraception is vital to prevent unnecessary maternal deaths, as well as sexually transmitted infections. The objective of this study was to investigate preferred contraceptive methods and the factors that influence contraceptive choice among women in Kelantan, Malaysia. A cross-sectional study using interview-based questionnaires was conducted, during July and August 2009, in local family planning clinics in Kelantan. The questionnaire was administered to adult women (age 20-50). Prevalence of unplanned pregnancies was high (48%). Contraceptive preference was Depo contraceptive injection (32%), oral contraceptive pills (27%), intrauterine devices (15%) and contraceptive implants (12%); 9% used condoms. Only 2% used contraception to protect against sexually transmitted infections or HIV/AIDS. Younger women (OR 0.90; 95% CI 0.807-0.993) were more likely to use contraception. In conclusion, non-interrupted contraceptive methods were preferred. More than 60% would stop using contraception if it interrupted intercourse. From both a public health and infectious disease perspective, this is extremely worrying. PMID:23970646

  6. Contraceptive Utilization and Pregnancy Termination Among Female Sex Workers in Afghanistan

    PubMed Central

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

    2010-01-01

    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 < 0.001) and prior termination (54.9% vs. 31.8% in Kabul or 26.8% in Mazar, p < 0.001). Most FSWs (90.0%) stated pregnancy was not currently desirable, and 85.2% were using 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

  7. Estrogen and Progestin (Oral Contraceptives)

    MedlinePlus

    ... occur before the menstrual period each month) in women who have chosen to use an oral contraceptive ... taking oral contraceptives. If you have had an abortion or miscarriage, talk to your doctor about when ...

  8. Directive counseling on long-acting contraception.

    PubMed Central

    Moskowitz, E; Jennings, B

    1996-01-01

    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

  9. Intrauterine Contraceptive Devices

    PubMed Central

    Cardoso, Reynaldo

    1983-01-01

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

  10. [Migraine and contraception].

    PubMed

    Cappy, H; Lucas, C; Catteau-Jonard, S; Robin, G

    2015-03-01

    Migraine is a common pathology in women. Migraine disease is well defined by the International Headache Society and has to be distinguished from others types of headaches. The occurrence of migraine attacks is frequently linked to the menstrual cycle. Many studies have related a connexion with hormonal fluctuations and migraine event. Migraine with aura is currently identified as a stroke risk factor and this risk dramatically increases in case of oestroprogestative pill intake and smoking. The World Health Organization established guidelines about oestroprogestative intake in case of migraine while strictly contraindicating oestroprogestative intake in patients with migraine with aura. This review explains the influence of different contraceptive intake, oral contraceptive regimens, and type of oestrogen in oestroprogestative contraceptive on migraine occurrence. PMID:25727163

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

    PubMed

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

    2007-07-01

    Asthma is an important public health challenge. The objective of this research was to investigate the relationship of air pollution and weather to adolescent asthma prevalence and attack rate. A 6-month mass screening asthma study was conducted from October 1995 to March 1996 in Taiwan. The study population included junior high school students from throughout the country (1,139,452 students). Eighty-nine percent of students completed questionnaires (International Study of Asthma and Allergies in Childhood-ISAAC and New England Core Questionnaires) and passed a logical screening error program. Lung function data was collected to assist in the diagnosis of asthma status. From the students screened during this mass survey, a stratified random sample of 64,660 students was analyzed for asthma prevalence and attack rate. Using a regression model to compare the USEPA National Ambient Air Quality Standards 2000 (NAAQS, 2000) to asthma prevalence, this investigation found that the standards may not provide enough protection for adolescents after controlling for age, rhinitis, eczema, urban birth location, parental education level, exercise, cigarette smoking, environmental tobacco smoking, alcohol beverage consumption and weather factors. The general estimating equations (GEE) model, a repeated measurement regression model, was used to examine the relationship between the monthly asthma attack rate among asthma patients and air pollution (nitrogen oxides; nitrogen dioxide; nitric oxide; Ozone; PM10) while controlling for household smoking. The GEE model demonstrated that air pollution is related to asthma attack rate. Air pollution factors also interacted with weather parameters when related to asthma attack rate. PMID:17316602

  12. Contraception in sea-going service personnel.

    PubMed

    Hawkins, D M; Booth, R

    2014-01-01

    The right to make an informed choice about contraception should be afforded to every individual serving within the United Kingdom (UK) Armed Forces. This article looks at the responsibilities and approach that healthcare professionals should take within a Primary Care setting, summarises the common contraceptive options available, discusses the associated advantages and disadvantages of each technique, and considers operational factors in a military environment that combine to influence the final contraceptive choice an individual makes. Case Study. A 19-year old Able Rate joined the Royal Navy (RN) and at her joining medical it was noted that she had been on Microgynon™ combined oral contraceptive pill for approximately three years. During this time, her menstrual periods remained light; she never experienced adverse effects, demonstrated good compliance, and was happy to remain on this contraceptive regimen. Over the course of the next eighteen months, she was reviewed by a number of Medical Officers and Civilian Medical Practitioners on a quarterly basis, with Microgynon™ re-prescribed on each occasion. The appropriate Defence Medical Information Capability Programme (DMICP) template was used, with weight, smoking status, compliance and any issues or comments documented accordingly. In December 2010, a discussion regarding long-acting reversible contraception (LARC) was documented for the first time. The patient agreed to give LARC some thought and a review appointment was made for one month. She was subsequently started on the progestogen-only pill Cerazette™. It was noted by the consulting doctor that both the patient's mother and grandmother had a positive history of cerebrovascular events and the combined oral contraceptive pill was discontinued. Upon review at two months, the patient reported that she was content on Cerazette™ and wished to continue with this medication. She was amenorrhoeic, highly compliant, had given up smoking and her weight and blood pressure were stable. However, due to supply issues, it was explained that Cerazette™ was no longer a viable option for her. She had no plans to start a family, and was keen to investigate other contraceptive options. Furthermore, she expressed a particular desire to remain amenorrhoeic, as she was due to deploy overseas in the coming months, and not only wanted to avoid the inconvenience of having her period, but also felt it preferable not to have to take a daily pill when considering the constantly changing time zones. She subsequently had the etonogestrel-releasing subdermal implant Nexplanon™ fitted without complication. She has remained amenorrhoeic throughout and this form of long-acting reversible contraception has particularly suited her busy working role and active lifestyle. PMID:25895414

  13. [Contraception during the perimenopause: indications, security, and non contraceptive benefits].

    PubMed

    Cantero Pérez, P; Klingemann, J; Yaron, M; Irion, N Fournet; Streuli, I

    2015-10-28

    Although patients' fertility is diminished in the period of perimenopause, they still need efficient contraception. Thorough knowledge of the physiological changes occuring during this period of transition is essential in order to provide optimal care. Until the age of 50, no contraceptive method is specifically considered unsuitable due to age alone. The choice of contraceptive needs to be adapted to the patient, assessing the individual risk factors and favouring the potential non-contraceptive advantages of the method selected. Long-term contraceptive methods (e.g., the copper intrauterine device (IUD), the Mirena IUD or a subcutaneous implant) offer an excellent solution on both levels. PMID:26672176

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

    PubMed Central

    2011-01-01

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

  15. Male contraception: a clinically-oriented review.

    PubMed

    Kanakis, George A; Goulis, Dimitrios G

    2015-10-01

    Despite the variety of available female contraceptive methods, many pregnancies (~50%) are still undesired. Many men (>60%) want to participate equally with their partner in family planning; however, male contraceptive methods (MCMs) account for only 14% of those used worldwide and no pharmaceutical MCM is available so far. The only two MCMs currently available are condoms, which despite protecting against sexually transmitted diseases have high failure rates (~19%), and vasectomy, which though very efficient (99%) is poorly reversible (<50%). Among MCMs under investigation, male hormonal contraceptives (MHCs) are those that have come closest to commercialization. The action of MHCs relies on the disruption of spermatogenesis that exogenous androgen administration evokes by suppressing the hypophyseal-gonadal axis. Various regimens of androgens as monotherapy or in combination with progestins have been tested in clinical trials achieving a Pearl Index <1.0 (equal to that of the female oral contraceptive pill); however, concerns regarding the variable response rates observed (non-responders: 5-20%), the impracticality of parenteral administration and long-term prostate-associated or cardiovascular morbidity have deflected the interest of the pharmaceutical industry from further research. Non-hormonal contraception methods may be, at least theoretically, more specific by selectively disrupting spermatogenesis and sperm transport or fertilizing ability. Nevertheless, only a few have been tested in clinical trials (Reversible Inhibition of Sperm Under Guidance, RISUG, and Intra Vas Plugs); most of them are still in pre-clinical development or have been abandoned due to toxicity (gossypol). Consequently, until a reliable, safe and practical MCM is developed, women will continue to bear most of the contraception burden. PMID:26732151

  16. Delivering non-hormonal contraceptives to men: advances and obstacles

    PubMed Central

    Mruk, Dolores D.; Cheng, C. Yan

    2014-01-01

    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

  17. Vaginal contraceptives merge old forms, new data.

    PubMed

    1983-07-01

    At the recent conference of the American College of Obstetricians and Gynecologists (ACOG), health care professionals concluded that, while there has been much speculative information in the past few years about the risks involved with vaginal contraceptives, women often prefer them over oral contraceptives (OCs) or an IUD. Dr. Gerald S. Bernstein, noted at the cervical cap symposium, sponsored by the Atlanta Feminist Women's Health Center, that the following are the most common vaginal contraceptive methods: solid barriers (cervical caps and diaphragms); vehicle barriers (contraceptive foams, creams, suppositories); or spermicides. Bernstein cited as major advantages of the methods their local action, their lack of systemic effects, and the few contraindications they may cause. The disadvantages included a requirement for user motivation, the association of some methods with coitus, inconvenience, messiness, and the necessity of manipulation. He also emphasized that the methods are less effective than the OCs or IUD in preventing pregnancy. Major safety issues or risks concerning vaginal and barrier methods are the toxicity of spermicides, effects of using spermicides after the user is pregnant, and trauma caused by some solid barriers. Whether or not spermicides used after a pregnancy occurs can cause congenital anomalies is still an unanswered question. It was Bernstein who discovered that the Vimule cervical cap could cause vaginal lesions of the portio vaginalis cervicis, ranging from erythematous impressions to abrasions and lacerations. He emphasized that trauma by a mechanical contraceptive device is probably not restricted to the Vimule cap. At this time Bernstein is completing a study to determine how long women should leave their cervical caps in place. Commenting that the cap is not yet approved for producation in the US, Dr. Daniel Mishell said at the ACOG conference that the vaginal contraceptive sponge is an attractive new means of vaginal contraception. The sponge, approved by the US Food and Drug Administration for 24 hour use, contains spermicide and is expected to have an efficacy rate similar to the diaphragm--in the 85% range. A new clinical study of women using the diaphragm with 2% nonoxynol-9 gel shows a failure rate much lower than average for other vaginal contraceptives. Dr. Bohdan Malyk reported that the combined method used in the 12-month independent study show a failure rate of 2.4%. PMID:12339358

  18. Prevalence and Predictive Value of Dyspnea Ratings in Hospitalized Patients: Pilot Studies

    PubMed Central

    Stevens, Jennifer P.

    2016-01-01

    Background Dyspnea (breathing discomfort) can be as powerfully aversive as pain, yet is not routinely assessed and documented in the clinical environment. Routine identification and documentation of dyspnea is the first step to improved symptom management and it may also identify patients at risk of negative clinical outcomes. Objective To estimate the prevalence of dyspnea and of dyspnea-associated risk among hospitalized patients. Design Two pilot prospective cohort studies. Setting Single academic medical center. Patients Consecutive patients admitted to four inpatient units: cardiology, hematology/oncology, medicine, and bariatric surgery. Measurements In Study 1, nurses documented current and recent patient-reported dyspnea at the time of the Initial Patient Assessment in 581 inpatients. In Study 2, nurses documented current dyspnea at least once every nursing shift in 367 patients. We describe the prevalence of burdensome dyspnea, and compare it to pain. We also compared dyspnea ratings with a composite of adverse outcomes: 1) receipt of care from the hospital’s rapid response system, 2) transfer to the intensive care unit, or 3) death in hospital. We defined burdensome dyspnea as a rating of 4 or more on a 10-point scale. Results Prevalence of burdensome current dyspnea upon admission (Study 1) was 13% (77 of 581, 95% CI 11%-16%). Prevalence of burdensome dyspnea at some time during the hospitalization (Study 2) was 16% (57 of 367, 95% CI 12%-20%). Dyspnea was associated with higher odds of a negative outcome. Conclusions In two pilot studies, we identified a significant symptom burden of dyspnea in hospitalized patients. Patients reporting dyspnea may benefit from a more careful focus on symptom management and may represent a population at greater risk for negative outcomes. PMID:27070144

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

    PubMed Central

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

    2013-01-01

    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

  20. Psychological, social, and spiritual effects of contraceptive steroid hormones.

    PubMed

    Klaus, Hanna; Cortés, Manuel E

    2015-08-01

    Governments and society have accepted and enthusiastically promoted contraception, especially contraceptive steroid hormones, as the means of assuring optimal timing and number of births, an undoubted health benefit, but they seldom advert to their limitations and side effects. This article reviews the literature on the psychological, social, and spiritual impact of contraceptive steroid use. While the widespread use of contraceptive steroid hormones has expanded life style and career choices for many women, their impact on the women's well-being, emotions, social relationships, and spirituality is seldom mentioned by advocates, and negative effects are often downplayed. When mentioned at all, depression and hypoactive sexual desire are usually treated symptomatically rather than discontinuing their most frequent pharmacological cause, the contraceptive. The rising incidence of premarital sex and cohabitation and decreased marriage rates parallel the use of contraceptive steroids as does decreased church attendance and/or reduced acceptance of Church teaching among Catholics. Lay summary: While there is wide, societal acceptance of hormonal contraceptives to space births, their physical side effects are often downplayed and their impact on emotions and life styles are largely unexamined. Coincidental to the use of "the pill" there has been an increase in depression, low sexual desire, "hook-ups," cohabitation, delay of marriage and childbearing, and among Catholics, decreased church attendance and reduced religious practice. Fertility is not a disease. Birth spacing can be achieved by natural means, and the many undesirable effects of contraception avoided. PMID:26912936

  1. Attitudes toward abortion and contraception among Nigerian secondary school girls.

    PubMed

    Oronsaye, A U; Odiase, G I

    1983-10-01

    A study of the attitudes of school girls in Benin City, Nigeria, toward abortion and contraception was carried out in three of the city's postprimary schools, using a uniform multiple-choice questionnaire. The findings show that although a significant proportion of the school girls had resorted to abortion to solve their problem of unwanted pregnancy, liberalized abortion law was only favored by a minority (approx. 30%). Also, although this indicated a high rate of sexual activity, their knowledge and practice of contraception and contraceptive methods is deficient and prejudiced. The latter findings may be responsible for the high rate of abortion among school girls in Nigeria. PMID:6141102

  2. The state of the contraceptive art.

    PubMed

    Tyrer, L B; Duarte, J

    1983-01-01

    The high failure rates of available contraceptive methods attest to the fact that the present technology is inadequate to meet the needs of many women, and new, safer, and highly effective contraceptive methods must be developed for both the female and the male. Previously, industry was largely responsible for the research and development of many of the currently available contraceptives, but at this time it is less than enthusiastic about carrying out further research because of the time and cost associated with the approval of new drugs. Additionally, because of the medico legal climate that exists today, particularly concerning present contraceptive drugs and devices, pharmaceutical companies are concentrating on developing drugs for the treatent of disease conditions, a less risky area. The US federal government, which currently is the single largest funder in the world of contraceptive and related research, is directing little attention to this particular area. The most obvious obstacles to enhanced federal support is the debate over the federal budget priorities. Other deterring factors include the controversy over abortion which has discouraged efforts to call attention to contraceptive research because of concern that it might result in funding cuts instead of increases. Another factor is the traditional allocation of 40% of National Institute of Health funds to population research and 60% to maternal and child health. An overview of currently available contraceptive methods covers oral contraception (OC), long lasting injectable contraception, IUDs, the condom, vaginal contraceptive sponge, the diagphragm, and fertility awareness techniques. Determining the actual benefits versus the risks of OC has proved difficult. OC has changed considerably since it came into use. The most serious side effects attributed to the OCs involve the cardiovascular system, specifically thromboembolism, stroke, and heart attack. The risk of developing these diseases has declined as the dosage of hormones in the pill has been decreased. Yet, other specific factors can increase the degree of risk. Overall, the OC is still one of the safest and most effective methods of preventing unwanted pregnancy. The Food and Drug Administration (FDA) has denied its approval of Depo-Provera, 1 of several long acting progestins, because of its association with breast tumors in the beagle dog and because of bleeding problems and delays in the return of fertility in human females. All IUDs have potential adverse side effects. The major ones continue to be cramping, bleeding, and infection. The IUD requires only a single act of motivation on the part of the patient, a definite advantage. Condoms of all types continue to be one of the most widely used forms of contraception at this time. The major disadvantage of vaginal chemical contraceptives is that they are coitally related and not aesthetically pleasing. The FDA recently approved for consumer use a polyurethane foam sponge containing a spermicide that is released gradually over a 24-hour period. The diaphragm is effective and has no serious side effects. The failure rate of the various fertility awareness methods is higher than other methods. PMID:12265618

  3. Comparative study on the acceptance and use of contraceptive methods in a rural population in Kelantan.

    PubMed

    Kamalanathan, J P

    1990-12-01

    Contraceptive prevalence was determined in the Kelantan region of Malaysia, an area with relatively poor health indices. 350 women attending health clinics on rubber and palm-oil estates and living in surrounding suburbs were surveyed by clinic workers or during home visits. The sample included 273 Malays, 64 Indians and 13 Chinese. This area of Peninsular Malaysia is noted for the highest infant mortality rate (17.7), second highest crude birth rate (35.2) and highest dependency ratio (88%) in the country. 44.9% practiced contraception, highest in Chinese and lowest in Indians. Methods used were pills by (55%), traditional methods (19%), tubal ligation (18%), safe period (14%), injections (5.5%), IUD (4.7%), and condom (2.3%). The Malaysian traditional methods are herbal preparations from tree bark or roots, herb pills, and exercises after coitus. 34% of the non contraceptors had used contraception before but stopped because of side effects, religious or spousal objections, or desire to conceive. 74% had married in their teens. 46% of the non-contraceptors were spacing their children by prolonged breastfeeding. PMID:12343150

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

    PubMed

    Rowlands, S; Devalia, H; Lawrenson, R

    2001-01-01

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

  5. Contraceptive Beach Ball

    ERIC Educational Resources Information Center

    Ellis, Edith B.; Miller, Deborah A.

    2005-01-01

    Abstinence-based sexuality education includes a discussion about the various types of contraception available today. This lesson addresses the knowledge and skills identified in the National Health Education Standards, and can be used with two different audiences-students and teachers. Included in the lesson are step-by-step procedures, a…

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

    PubMed

    Carothers, A D; Hecht, C A; Hook, E B

    1999-05-01

    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 under-ascertainment. 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. PMID:10353785

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

    PubMed Central

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

    2013-01-01

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

  8. Personal stigma in schizophrenia spectrum disorders: a systematic review of prevalence rates, correlates, impact and interventions

    PubMed Central

    Gerlinger, Gabriel; Hauser, Marta; De Hert, Marc; Lacluyse, Kathleen; Wampers, Martien; Correll, Christoph U

    2013-01-01

    A systematic electronic PubMed, Medline and Web of Science database search was conducted regarding the prevalence, correlates, and effects of personal stigma (i.e., perceived and experienced stigmatization and self-stigma) in patients with schizophrenia spectrum disorders. Of 54 studies (n=5,871), published from 1994 to 2011, 23 (42.6%) reported on prevalence rates, and 44 (81.5%) reported on correlates and/or consequences of perceived or experienced stigmatization or self-stigma. Only two specific personal stigma intervention studies were found. On average, 64.5% (range: 45.0–80.0%) of patients perceived stigma, 55.9% (range: 22.5–96.0%) actually experienced stigma, and 49.2% (range: 27.9–77.0%) reported alienation (shame) as the most common aspect of self-stigma. While socio-demographic variables were only marginally associated with stigma, psychosocial variables, especially lower quality of life, showed overall significant correlations, and illness-related factors showed heterogeneous associations, except for social anxiety that was unequivocally associated with personal stigma. The prevalence and impact of personal stigma on individual outcomes among schizophrenia spectrum disorder patients are well characterized, yet measures and methods differ significantly. By contrast, research regarding the evolution of personal stigma through the illness course and, particularly, specific intervention studies, which should be conducted utilizing standardized methods and outcomes, are sorely lacking. PMID:23737425

  9. CUP: contraceptive users pamphlet.

    PubMed

    1986-02-01

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

  10. Use of modern contraceptives among married women in Vietnam: a multilevel analysis using the Multiple Indicator Cluster Survey (2011) and the Vietnam Population and Housing Census (2009)

    PubMed Central

    Vu, Lan Thi Hoang; Oh, Juhwan; Bui, Quyen Thi-Tu; Le, Anh Thi-Kim

    2016-01-01

    Background The prevalence of modern contraceptive use is an important indicator that reflects accessibility to reproductive health services. Satisfying unmet needs for family planning alone could reduce the number of maternal deaths by almost a third. This study uses multiple data sources to examine multilevel factors associated with the use of modern contraceptives among married women in Vietnam aged 15–49 years. Design Data from different national surveys (Vietnam Population and Housing Census, Vietnam Living Standard Survey, and Multiple Indicator Cluster Survey) were linked to create a dataset including individual and contextual (provincial) variables (N=8,341). Multilevel modeling was undertaken to examine the impact of both individual and provincial characteristics on modern contraceptive use. Odds ratios (ORs) and 95% confidence intervals (CIs) are reported. Results Individual factors significantly associated with the use of modern contraceptives were age 30–34 years (reference 15–19 years) (OR=1.63); high socioeconomic status (SES) (OR=0.8); having two living children (OR=2.4); and having a son (OR=1.4). The provincial poverty rate mediated the association between the individual's SES and the likelihood of using modern contraceptives. Conclusions The proportion of women in Vietnam using modern contraceptive methods has remained relatively high in recent years with significant variation across Vietnam's 63 provinces. Women of lower SES are more likely to use modern contraceptive methods, especially in the poorer provinces. Achieving access to universal reproductive health is one of the Millennium Development Goals. Vietnam must continue to make progress in this area. PMID:26950565

  11. Scaling Up Family Planning to Reduce Maternal and Child Mortality: The Potential Costs and Benefits of Modern Contraceptive Use in South Africa

    PubMed Central

    Chola, Lumbwe; McGee, Shelley; Tugendhaft, Aviva; Buchmann, Eckhart; Hofman, Karen

    2015-01-01

    Introduction Family planning contributes significantly to the prevention of maternal and child mortality. However, many women still do not use modern contraception and the numbers of unintended pregnancies, abortions and subsequent deaths are high. In this paper, we estimate the service delivery costs of scaling up modern contraception, and the potential impact on maternal, newborn and child survival in South Africa. Methods The Family Planning model in Spectrum was used to project the impact of modern contraception on pregnancies, abortions and births in South Africa (2015-2030). The contraceptive prevalence rate (CPR) was increased annually by 0.68 percentage points. The Lives Saved Tool was used to estimate maternal and child deaths, with coverage of essential maternal and child health interventions increasing by 5% annually. A scenario analysis was done to test impacts when: the change in CPR was 0.1% annually; and intervention coverage increased linearly to 99% in 2030. Results If CPR increased by 0.68% annually, the number of pregnancies would reduce from 1.3 million in 2014 to one million in 2030. Unintended pregnancies, abortions and births decrease by approximately 20%. Family planning can avert approximately 7,000 newborn and child and 600 maternal deaths. The total annual costs of providing modern contraception in 2030 are estimated to be US$33 million and the cost per user of modern contraception is US$7 per year. The incremental cost per life year gained is US$40 for children and US$1,000 for mothers. Conclusion Maternal and child mortality remain high in South Africa, and scaling up family planning together with optimal maternal, newborn and child care is crucial. A huge impact can be made on maternal and child mortality, with a minimal investment per user of modern contraception. PMID:26076482

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

    ERIC Educational Resources Information Center

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

    2011-01-01

    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…

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

    ERIC Educational Resources Information Center

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

    2011-01-01

    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

  14. Nomegestrol acetate-17b-estradiol for oral contraception.

    PubMed

    Burke, Anne

    2013-01-01

    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

  15. Nomegestrol acetate-17b-estradiol for oral contraception

    PubMed Central

    Burke, Anne

    2013-01-01

    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

  16. Effect of oral contraceptives on respiratory function.

    PubMed

    Resmi, S S; Samuel, Elizabeth; Kesavachandran, C; Shashidhar, Shankar

    2002-07-01

    The present study was carried out to assess the lung functions in oral contraceptive administered women. Lung function tests were carried out with Spirometer (Vitallograph Compact II). A significant increase in vital capacity (VC) was observed in these women as compared to normal control. There was also a significant decrease in forced expiratory volume in 1 sec./vital capacity (FEV1/VC%) and forced expiratory volume in 1 sec./forced vital capacity (FEV1/FVC%) among oral contraceptive administered women as compared to controls. Further, a significant increase in peak expiratory flow rate (PEF), reduction in forced expiratory flow rate (FEF75-85%) and FEF75% were observed among oral contraceptive administered women as compared to controls. The increase in VC and PEF might be due to the synthetic form of progesterone (progestins) present in oral contraceptive pills which causes hyperventilatory changes. Synthetic progesterone during luteal phase of menstrual cycle might increase the static and dynamic volumes of lung i.e. VC and PEF. But FEF75% showed a decrease which might be due to the lower neuromuscular coordination during breathing. PMID:12613402

  17. [The women and the right to contraceptives].

    PubMed

    Charchafche, Helena; Nilsson, Peter M

    2007-01-01

    During the first decades of the 20th century, many Swedish women were severely injured or died in complications following illegal abortions. Since legal abortion was forbidden, contraceptives were the only way to avoid pregnancy. But in the year 1910, a new Swedish law "Preventivlagen" prohibited any kind of advertising och public information considering contraceptives. They could still be sold in pharmacies or special medical stores, but it was no longer allowed to speak publicly about contraceptives in a leading manner. The punishment for disobeying was prison or fines. Some physicians and people involved in women liberation, public health and/or public education, claimed that the law brought negative medical, social and economic consequences, while others opposed the law being too soft. The law made the more than 100 years old question about contraceptives or not, a part of the medical, political and social agenda for the society. Some argument against contraceptives was concerned about the decreasing nativity rate--more use of contraceptives could make an even worse situation. Another reason was the fear of an increasing promiscuity if the contraceptives were more available. Still, many physicians and womens liberators did not se this as any big and important problems. They were more concerned about the women's health and her right to give birth to children at the time she wanted. Women had their right to be in charge of their lives, and should no longer be seen as victims of their biological nature. The right to contraceptives was not the only topic to be discussed during the late 19th century and the first decades of the 20th century. Another central right to be claimed, was the possibility for people, especially young people, to be educated in sexual questions. Many women and also women physicians fought for young peoples right to this information. The law "Preventivlagen" was abolished in 1938. After that, women hade their legal right to choose for themselves at what time they wanted to get pregnant and also the number of children. PMID:18548951

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

    PubMed Central

    2012-01-01

    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

  19. Preventing Unintended Pregnancies by Providing No-Cost Contraception

    PubMed Central

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

    2014-01-01

    OBJECTIVE To promote the use of long-acting reversible contraceptive methods (LARC) (intrauterine devices and implants) and provide contraception at no cost to a large cohort of participants in an effort to reduce unintended pregnancies in our region. METHODS We enrolled 9,256 adolescents and women at risk for unintended pregnancy into the Contraceptive CHOICE Project, a prospective cohort study of adolescents and women desiring reversible contraceptive methods. Participants were recruited from the two abortion facilities in the St. Louis region and through provider referral, advertisements, and word of mouth. Contraceptive counseling included all reversible methods, but emphasized the superior effectiveness of LARC methods (IUDs and implants). All participants received the reversible contraceptive method of their choice at no cost. We analyzed abortion rates, the percentage of abortions that are repeat abortions, and teenage births. RESULTS We observed a significant reduction in the percentage of abortions that are repeat abortions in the St. Louis region compared to Kansas City and nonmetropolitan Missouri (P < 0.001). Abortion rates of the CHOICE cohort were less than half the regional and national rates (P < 0.001). The rate of teenage birth within the CHOICE cohort was 6.3 per 1,000, compared to the U.S. rate of 34.1 per 1,000. CONCLUSION We noted a clinically and statistically significant reduction in abortion rates, repeat abortions, and teenage birth rates. Unintended pregnancies may be reduced by providing no-cost contraception and promoting the most effective contraceptive methods. PMID:23168752

  20. The contraceptive implant and the injectable: a comparison of costs.

    PubMed

    Westfall, J M; Main, D S

    1995-01-01

    A comparison of the relative costs of the injectable contraceptive (depot medroxyprogesterone acetate) and the hormonal implant (Norplant) indicates that the implant is a less costly contraceptive option when it is used for its full five-year lifespan. Over a five-year period, the implant costs $107 annually, compared with $140 per year for the injectable. However, if a woman discontinues the implant before she has used it for at least four years, the injectable becomes the less costly option. Relatively high continuation rates--around 95% annually--are necessary to make the implant the more cost-effective contraceptive method. PMID:7720851

  1. Changes in hypertension prevalence, awareness, treatment, and control rates in Turkey from 2003 to 2012

    PubMed Central

    Sengul, Sule; Akpolat, Tekin; Erdem, Yunus; Derici, Ulver; Arici, Mustafa; Sindel, Sukru; Karatan, Oktay; Turgan, Cetin; Hasanoglu, Enver; Caglar, Sali; Erturk, Sehsuvar

    2016-01-01

    Objectives: The study aimed to assess the current epidemiology of hypertension, including its prevalence, the awareness of the condition and its treatment and control, in Turkey to evaluate changes in these factors over the last 10 years by comparing the results with the prevalence, awareness, treatment, and control of hypertension in Turkey (PatenT) study data (2003), as well as to assess parameters affecting awareness and the control of hypertension. Methods: The PatenT 2 study was conducted on a representative sample of the Turkish adult population (n = 5437) in 2012. Specifically trained staff performed the data collection. Hypertension was defined as mean SBP or DBP at least 140/90 mmHg, previously diagnosed disease or the use of antihypertensive medication. Awareness and treatment were assessed by self-reporting, and control was defined as SBP/DBP less than 140/90 mmHg. Results: Although the prevalence of hypertension in the PatenT and PatenT 2 surveys was stable at approximately 30%, hypertension awareness, treatment, and control rates have improved in Turkey. Overall, 54.7% of hypertensive patients were aware of their diagnosis in 2012 compared with 40.7% in 2003. The hypertension treatment rate increased from 31.1% in 2003 to 47.4% in 2012, and the control rate in hypertensives increased from 8.1% in 2003 to 28.7% in 2012. The rate of hypertension control in treated patients improved between 2003 (20.7%) and 2012 (53.9%). Awareness of hypertension was positively associated with older age, being a woman, residing in an urban area, a history of parental hypertension, being a nonsmoker, admittance by a physician, presence of diabetes mellitus, and being obese or overweight; it was inversely associated with a higher amount of daily bread consumption. Factors associated with better control of hypertension were younger age, female sex, residing in an urban area, and higher education level in Turkey. Conclusion: Although some progress has been made in recognizing hypertension from 2003 to 2012, there is still a large population of untreated or inadequately treated hypertensives in Turkey. Strengthening of population-based efforts to improve the prevention, early detection, and treatment of hypertension is needed. PMID:26991534

  2. Postabortal and postpartum contraception.

    PubMed

    Cameron, Sharon

    2014-08-01

    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

  3. Designer contraceptive pills.

    PubMed

    Hsueh, A J

    1995-08-01

    The present world population of 5.6 billion is projected to reach 9 billion by the year 2025. Overpopulation remains one of the overwhelming issues of the 21st century, but only limited effort and resources have been allocated to designing new contraceptives, as evidenced by the diminished interest of the pharmaceutical industry and funding agencies. Major advances have been made recently in our understanding of the genetic basis of an individual's risk to various reproductive cancers and sex steroid-related diseases. It has also become apparent that agonistic and antagonistic analogues of sex steroids with tissue-specific actions can be formulated. These new insights provide the opportunity to develop the next generation of 'designer' contraceptive pills with disease-prevention benefits. PMID:8567829

  4. Do antimicrobials increase the carriage rate of penicillin resistant pneumococci in children? Cross sectional prevalence study.

    PubMed Central

    Arason, V. A.; Kristinsson, K. G.; Sigurdsson, J. A.; Stefánsdóttir, G.; Mölstad, S.; Gudmundsson, S.

    1996-01-01

    OBJECTIVE: To study the correlation of antimicrobial consumption with the carriage rate of penicillin resistant and multiresistant pneumococci in children. DESIGN: Cross sectional and analytical prevalence study. SETTING: Five different communities in Iceland. MAIN OUTCOME MEASURE: Prevalence of nasopharyngeal carriage of penicillin resistant pneumococci in children aged under 7 years in relation to antibiotic use as determined by information from parents, patient's records, and total sales of antimicrobials from local pharmacies in four study areas. RESULTS: Total antimicrobial sales for children (6223 prescriptions) among the four areas for which data were available ranged from 9.6 to 23.2 defined daily doses per 1000 children daily (1.1 to 2.6 courses yearly per child). Children under 2 consumed twice as much as 2-6 year olds (20.5 v 10.9 defined daily doses per 1000 children daily). Nasopharyngeal specimens were obtained from 919 children, representing 15-38% of the peer population groups in the different areas. Pneumococci were carried by 484 (52.7%) of the children, 47 (9.7%) of the isolates being resistant to penicillin or multiresistant. By multivariate analysis age (< 2 years), area (highest antimicrobial consumption), and individual use of antimicrobials significantly influenced the odds of carrying penicillin resistant pneumococci. By univariate analysis, recent antimicrobial use (two to seven weeks) and use of co-trimoxazole were also significantly associated with carriage of penicillin resistant pneumococci. CONCLUSIONS: Antimicrobial use, with regard to both individual use and total antimicrobial consumption in the community, is strongly associated with nasopharyngeal carriage of penicillin resistant pneumococci in children. Control measures to reduce the prevalence of penicillin resistant pneumococci should include reducing the use of antimicrobials in community health care. PMID:8761224

  5. Sexual health and contraception.

    PubMed

    Straw, Fiona; Porter, Charlotte

    2012-10-01

    Sexual health encompasses 'sexual development and reproductive health, as well as the ability to develop and maintain meaningful interpersonal relationships; appreciate one's own body; interact with both genders in respectful and appropriate ways; express affection, love and intimacy in ways consistent with one's own values'. The 2008 WHO Consensus Statement additionally noted that 'responsible adolescent intimate relationships' should be 'consensual, non-exploitative, honest, pleasurable and protected against unintended pregnancy and STDs if any type of intercourse occurs'. Young people (YP) must, therefore, be able to access sexual health information and services that meet their needs. For most YP, interest in sexual activity begins with puberty, and this is associated with increasingly sexualised behaviour, including exploration of themselves and others. Most YP find this a confusing time, and so it is important that health professionals are able to offer advice regarding the wide range of sexual health issues, including sexuality, choice of partner, contraception, risk and management of sexually transmitted infections (STI) in a confident and approachable manner. YP have never had so much choice or information available to them, and this can be confusing for them. There is good evidence that YP who get information from their parents are likely to initiate sexual activity later than their peers who access information from their friends. However, there is also evidence that some YP would prefer to get sexual health information from health professionals. It is therefore imperative that all health professionals who see YP have an awareness of sexual health issues, and know where to signpost YP should they need more specialist sexual health advice and/or treatment. Where appropriate, one-to-one sexual health advice should be provided to YP on how to prevent and get tested for STIs, and how to prevent unwanted pregnancies. Advice should also be given on all methods of reversible contraception, including long-acting reversible contraception, emergency contraception and other reproductive issues. PMID:22983512

  6. [Pregnancy, contraception and epilepsy].

    PubMed

    Leppert, D; Wieser, H G

    1993-08-01

    Epilepsy is the most common neurological disease of females in reproductive age. Problems concerning contraception, reproduction, teratogenicity and antiepileptic therapy preceding and during pregnancy are discussed and recommendations made. We underline the advantages of a planned pregnancy with optimal adjustment of antiepileptic drug therapy and recommend prophylactic treatment with folic acid before and during, and with vitamin K towards the end of pregnancy. PMID:8413747

  7. Factors in adolescent contraceptive use.

    PubMed

    Kellinger, K G

    1985-09-01

    This study examined three variables--knowledge of contraception, self-esteem and religiosity-and the relationship of each variable to the use of contraception among unmarried adolescent women. A questionnaire designed to measure contraceptive knowledge, self-esteem and religiosity was administered to 28 pregnant, unmarried adolescents and to 31 unmarried, never-pregnant, adolescent contraceptive users. A t-Test was used to measure the significance of the relationship of the three independent variables to the dependent variable, contraceptive use. Upon analysis of the data, no significant difference was found between either group in relation to their knowledge of contraception, self-esteem scores or religious attitudes; however, some additional data were gathered from the research tool that may provide areas for future investigation. PMID:4058815

  8. [Emergency oral contraception policy: the Peruvian experience].

    PubMed

    Pretell-Zárate, Eduardo A

    2013-07-01

    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

  9. Contraceptives versus abortifacients.

    PubMed

    Barber, H R

    1990-11-01

    A less-publicized aspect of the famed Louisiana abortion bill would have outlawed the use of IUDs and oral contraceptives (OCs), a provision that ignores the difference between contraceptives and abortifacients. The bill, which was vetoed by Governor Buddy Roemer, stirred widespread controversy in its effort to sharply restrict abortion. Many of those involved in the discussion -- including the State Attorney General's office -- have contended that IUDs and OCs induce abortions by destroying fertilized eggs. But such statements disregard scientific studies that indicate that both contraceptive methods work by preventing fertilization. Research has shown that IUDs, especially copper-IUDs, restrict the transport of sperm, thereby preventing fertilization. One study revealed the presence of sperm in the fallopian tubes of non-IUD users 15-30 minutes after insemination, but found no sperm in the tubes of IUD users. Inhibiting ovulation, OCs work through a combination of estrogen and progestin. OCs prevent fertility by activating various mechanisms: they suppress the release of certain hormones, and cause a thickening of the cervical mucus which impairs sperm motility. Although neither IUDs nor OCs can be considered abortifacients, a small but vocal minority has succeeded in obscuring this fact. And it is the role of science to resolve the controversy by making the facts clear. PMID:12343158

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

    PubMed

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

    2014-11-01

    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

  11. Report calls for new revolution in contraceptive technology.

    PubMed

    Durbin, S

    1996-09-01

    In response to the high rates of contraceptive failure and abortion in the US, members of an Institute of Medicine (National Academy of Sciences) panel called for a "second contraceptive revolution." Since oral contraceptives were introduced in the early 1960s, social, legal, and financial barriers have stalled any further development of new methods. Most research activity has focused on modifying existing hormonal methods rather than creating new technology. Essential is stronger collaboration between government, industry, private insurers, and the public. Product liability concerns have been a major obstacle, in the US more than in other countries. Thus, the panel called for a statute that would protect manufacturers from certain lawsuits if their contraceptives had been approved by the US Food and Drug Administration. Given the pharmaceutical industry's insistence on clearer drug regulatory protocol as a condition of contraceptive development, the panel recommended immediate guidelines for high-priority areas such as spermicides and vaginal microbicides. To spread the legal and financial risks associated with the development of anti- and post-implantation methods such as RU-486, the panel urged that small biotech firms form partnerships with nonprofit organizations and large pharmaceutical companies. Another option for new contraceptive development is a global contraceptive commodity program or multilateral purchasing pool, in which competing manufacturers would be eligible for volume purchases of their products by the sponsoring agencies. PMID:12291557

  12. Advances in male hormonal contraception

    PubMed Central

    Antonietta, Costantino; Giulia, Gava; Marta, Berra; Cristina, Meriggiola Maria

    2014-01-01

    Contraception is a basic human right for its role on health, quality of life and wellbeing of the woman and of the society as a whole. Since the introduction of female hormonal contraception the responsibility of family planning has always been with women. Currently there are only a few contraceptive methods available for men, but recently, men have become more interested in supporting their partners actively. Over the last few decades different trials have been performed providing important advances in the development of a safe and effective hormonal contraceptive for men. This paper summarizes some of the most recent trials. PMID:25673544

  13. Contraception: a social revolution.

    PubMed

    Benagiano, Giuseppe; Bastianelli, Carlo; Farris, Manuela

    2007-03-01

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

  14. 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

    2014-01-01

    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

  15. Computers and Contraception: Strange Bedfellows? Contraception Education Survey.

    ERIC Educational Resources Information Center

    Gonyer, Pamela G.

    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…

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

    PubMed

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

    2015-02-01

    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

  17. Efficacy of a combined contraceptive regimen consisting of condoms and emergency contraception pills

    PubMed Central

    2014-01-01

    Background To evaluate and compare the effectiveness of the combined regimen (consisting of condoms and emergency contraception pills (ECP)) and using condoms only for the purpose of preventing pregnancy. Methods One-thousand-five-hundred-and-sixty-two (1,562) couples as volunteers enrolled at nine centers in Shanghai. Eight-hundred-and-twelve (812) were randomized to use male condoms and ECP (i.e., Levonorgestrel) as a back-up to condoms (the intervention group) and 750 to use male condoms only(the control group), according to their working unit. Participants were visited at admission and at the end of 1, 3, 6, 9, and 12 months. The cumulative life table rates were calculated for pregnancy and other reasons for discontinuation. Result The gross cumulative life table rates showed that the cumulative discontinuation rates for all reasons during the year of follow-up in the condoms plus emergency contraception group and the condoms only group were 7.76 ± 0.94 and 6.61 ± 0.91, respectively, per 100 women (χ2 = 0.41, p = 0.5227). The cumulative gross pregnancy rate of the condoms plus emergency contraception group and the condoms only group were 2.17 ± 0.52 and 1.25 ± 0.41, respectively, per 100 women (χ2 = 1.93, p = 0.1645). The Pearl Index in the condoms plus emergency contraception group and the condoms only group were 2.21% and 1.26%, respectively. Conclusion Male condoms remain a highly effective contraceptive method for a period of one year while consistently and correctly used. In addition, the lowest pregnancy rate followed from perfect use condom. PMID:24725355

  18. Prescription contraception use: a cross-sectional population study of psychosocial determinants

    PubMed Central

    Molloy, Gerard J; Sweeney, Leigh-Ann; Byrne, Molly; Hughes, Carmel M; Ingham, Roger; Morgan, Karen; Murphy, Andrew W

    2015-01-01

    Objective Many forms of contraception are available on prescription only for example, the oral contraceptive pill (OCP) and long-acting reversible contraceptives (LARCs). In this analysis we aim to identify key determinants of prescription contraceptive use. Design Cross-sectional population survey. Data on sociodemographic indices, concerns about the OCP and perceived barriers to access were collected. Setting Data set constructed from a representative population-based telephone survey of community dwelling adults in the Republic of Ireland (RoI) Participants 1515 women aged between 18 and 45 years Main outcome measure Self-reported user of the OCP or LARCs (intrauterine contraception, contraceptive injections or subdermal contraceptive implants) in the previous 12 months. Results For at least some of the previous year, 35% had used the OCP and 14% had used LARCs, while 3% had used two or more of these methods. OCP users were significantly younger, more likely to be unmarried and had higher income than non-users. Overall, 68% agreed with the statement ‘that taking a break from long-term use of the contraceptive pill is a good idea’ and 37% agreed with the statement that ‘the OCP has dangerous side effects’ and this was the strongest predictor variable of non-use of the OCP. Intrauterine contraception users were significantly older, more likely to be married and had lower income than non-users. Injections or subdermal contraceptive implant users were significantly younger, less likely to be married, had lower income and were less likely to agree that taking a break from long-term use of the pill is a good idea than non-users. Conclusions Prescription contraceptive use is sociodemographically patterned, with LARCs in particular being associated with lower incomes in the RoI. Concerns about the safety of the OCP remain prevalent and are important and modifiable determinants of contraceptive-related behaviour. PMID:26270944

  19. Mapping the serological prevalence rate of West Nile fever in equids, Tunisia.

    PubMed

    Bargaoui, R; Lecollinet, S; Lancelot, R

    2015-02-01

    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

  20. Early Generalized Overgrowth in Autism Spectrum Disorder: Prevalence Rates, Gender Effects, and Clinical Outcomes

    PubMed Central

    Campbell, Daniel J.; Chang, Joseph; Chawarska, Katarzyna

    2014-01-01

    Objective Although early head and body overgrowth have been well-documented in autism spectrum disorder (ASD), their prevalence and significance remain unclear. It is also unclear whether overgrowth affects males and females differentially, and whether it is associated with clinical outcomes later in life. Method To evaluate prevalence of somatic overgrowth, gender effects, and associations with clinical outcomes, head circumference, height, and weight measurements were collected retrospectively between birth and 2 years of age in toddlers with ASD (n=200) and typically developing (TD; n=147) community controls. Symptom severity, verbal, and nonverbal functioning were assessed at 4 years. Results Abnormalities in somatic growth in infants with ASD were consistent with early generalized overgrowth (EGO). Boys but not girls with ASD were larger and exhibited an increased rate of extreme EGO compared to community controls (18.0% versus 3.4%). Presence of a larger body at birth and postnatal overgrowth were associated independently with poorer social, verbal, and nonverbal skills at 4 years. Conclusion Although early growth abnormalities in ASD are less common than previously thought, their presence is predictive of lower social, verbal, and nonverbal skills at 4 years, suggesting that they may constitute a biomarker for identifying toddlers with ASD at risk for less-optimal outcomes. The results highlight that the search for mechanisms underlying atypical brain development in ASD should consider factors responsible for both neural and non-neural tissue development during prenatal and early postnatal periods, and can be informed by the finding that early overgrowth may be more readily observed in males than females with ASD. PMID:25245350

  1. Expanding contraceptive options.

    PubMed

    1989-01-01

    The goals of Family Health International (FHI) have been to introduce a variety of birth control options to people in developing countries, and to provide information to the user on the advantages and disadvantages of each method. FHI has worked with many developing countries in clinical trials of established as well as new contraceptive methods. These trials played an important part in making 2 sterilization procedures, laparoscopy and minilaparotomy popular for women. Further research improved the methods and have made them the most popular in the world, chosen by 130 million users. FHI is doing clinical trials on a new IUD, that is a copper bearing T-shaped device called the TCu380A. they have collected data on over 10,000 women using IUD's and early analysis indicates TCu380A is more effective than others. FHI is also evaluating devices such as Norplant that will prevent pregnancy up to 5 years by implanting the capsules in the arm. More than 8,000 women are being tested to determine the acceptability of implants in different geographical locations. Other research groups are doing work in 10 additional countries: Bangladesh will expand its program to 24,000 women and Nepal to 8,000 women. Trials are also being conducted on progestogen pills, since they do not lesson the volume of milk in breast feeding. FHI has also worked to introduce creative community-based distribution channels. In one case, specially trained health workers delivered contraceptives door-to-door in over 150,000 households. They found that 2 of 3 women accepted the pills and in a follow up survey 90% were still using them. FHI is now focusing on ways to improve moving new contraceptives from clinical testing on everyday use. They will coordinate training programs, educational material, media campaigns, and efforts with other international organizations, government agencies, and family planning groups. PMID:12283021

  2. [Macroprogestative contraception: advantages].

    PubMed

    Jamin, C

    1993-02-01

    Combined oral contraceptives (OCs) have nearly total efficacy when correctly used and good overall tolerance among most women under 40, but there are several significant contraindications to their use. Women with hypertension, hyperlipidemia, diabetes, minor mastopathy, or premenstrual tension should not use OCs containing estrogen. Macroprogestational OCs administered generally 20 days out of 28 are useful when an antiestrogen effect is sought or when metabolic anomalies are to be avoided. An antiestrogen effect may be desired for women over 40 suffering from relative or absolute hyperestrogenism, or for women with premenstrual syndrome, menorrhagia related to endometrial hyperplasia or other menstrual problems, or benign mastopathies. An antiestrogen effect may also be desired to prevent cellular pathologies common after age 40. Some anomalies of metabolism, blood pressure, and coagulation persist in users of combined OCs regardless of the dose or the compounds used in the formulation. Progestins derived from testosterone were the first to be used in contraception and provide good cycle control and antigonadotropic activity, along with a powerful antiestrogen effect. But they may have metabolic side effects and cause signs of hyperandrogenism. Progestins derived from progesterone have been studied in health women and in those with different risk factors. Chlormadinone acetate has been used in women at high vascular risk, and promegestone has been used in women with fibrocystic breast disorders. A study was also done on 36 healthy women for 6 months using nomegestrol acetate. The preliminary results were good but the numbers of women were small, they had no metabolic risk factors, and the treatment periods were short. The results thus cannot be extrapolated to subjects at risk or for use during longer periods. The only observed modifications (essentially declines in apoprotein A1 and elevation of antithrombine) were probably attributable to the decline in average estradiol levels and without significance for risk. A disadvantage of these methods is that they have not been authorized for marketing as contraceptives in France and no Pearl index is available. Although the incidence of menstrual problems is not well known, such problems appear to be relatively frequent. The hypoestrogenism often sought for women with gynecological pathologies is not necessarily desirable for women using these methods because of metabolic problems or age over 40. A sufficient estradiol level protects against premature bone loss and has important metabolic effects including better production HDL cholesterol. 18 women who experienced menstrual problems with macroprogestational contraceptives were given 5 mg/day of nomegestrol acetate in combination with transdermally administered estradiol. Clinical and metabolic tolerance were excellent, and no pregnancies occurred. Further study is warranted. PMID:12318009

  3. Phase of oral contraceptive cycle and endurance capacity of rowers.

    PubMed

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

    2011-12-01

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

  4. The contraceptive CHOICE project round up: what we did and what we learned.

    PubMed

    McNicholas, Colleen; Madden, Tessa; Secura, Gina; Peipert, Jeffrey F

    2014-12-01

    The Contraceptive CHOICE Project was a prospective cohort study of 9256 women in the St Louis area. The project provided no-cost reversible contraception to participants for 2 to 3 years with the goal of increasing uptake of long-acting reversible contraception and decreasing unintended pregnancy in the area. This manuscript will provide a brief summation of the major findings to date including the dramatic effect the project had on unintended pregnancy and abortion rates. PMID:25286295

  5. The Contraceptive CHOICE Project Round Up: what we did and what we learned

    PubMed Central

    McNicholas, Colleen; Tessa, Madden; Secura, Gina; Peipert, Jeffrey F.

    2014-01-01

    The Contraceptive CHOICE Project was a prospective cohort study of 9,256 women in the St. Louis area. The project provided no-cost reversible contraception to participants for 2-3 years with the goal of increasing uptake of long-acting reversible contraception and decreasing unintended pregnancy in the area. This manuscript will provide a brief summation of the major findings to date including the dramatic effect the project had on unintended pregnancy and abortion rates. PMID:25286295

  6. Nonspecific side effects of oral contraceptives: nocebo or noise?

    PubMed

    Grimes, David A; Schulz, Kenneth F

    2011-01-01

    Side effects of combined oral contraceptives are the most common reason why women discontinue them. Over the past half century, an elaborate mythology about these ill effects has evolved, fueled by rumor, gossip and poor-quality research. In contrast, placebo-controlled randomized trials document that nonspecific side effects are not significantly more common with combined oral contraceptives than with inert pills. These reported nonspecific side effects may reflect the nocebo phenomenon (the inverse of a placebo): if women are told to expect noxious side effects, these complaints occur because of the power of suggestion. Alternatively, nonspecific complaints may simply reflect their background prevalence in the population. Because Level I evidence documents no important increase in nonspecific side effects with oral contraceptives, counseling about these side effects or including them in package labeling is unwarranted and probably unethical. When in doubt, clinicians should err on the side of optimism. PMID:21134497

  7. Contraceptive discontinuation among married women in the United States.

    PubMed

    Grady, W R; Hayward, M D; Florey, F A

    1988-01-01

    Using data from the 1982 National Survey of Family Growth (NSFG), this analysis reports differentials in contraceptive discontinuation among married women aged 15-44 years in the United States. The total discontinuation rate is broken down into change to no method (termination) or to a different method (a method switch), and rates are obtained for specific methods. In addition, sociodemographic differences in risks associated with each type of discontinuation are shown. Discontinuation rates are compared to use-failure rates to provide a more comprehensive understanding of the implications of discontinuation for contraceptive efficacy. PMID:3176095

  8. Contraception and safer sex.

    PubMed

    Potts, M; Smith, J B

    1992-03-01

    Much remains to be learned about the microbiological dynamics of male to female heterosexual HIV transmission. Research has yet to determine whether infections results from female exposure to free virus in semen, HIV-infected white cells, or both. Once in the woman's reproductive tract, does HIV penetrate cervical mucus or vaginal epithelium, transverse a cervical ectopy, or enter the bloodstream at some alternative site. Empirical evidence does support the existence of differing degrees of individual HIV infectiousness and susceptibility. Male to female transmission is thought to be more efficient than vice versa, and infection with another STD is an important independent factor contributing to susceptibility to HIV. Given the difficulty of obtaining clinical data on these questions, it is difficult to advise people on their contraceptive options. This quandary rings especially true when one considers that some contraceptives may reduce the risk of HIV infection, while others may help facilitate its entry. With these concerns in mind, the authors discuss available information on chemical and mechanical barrier methods, natural methods such as breast feeding, ovulation prediction, and coitus interruptus, as well as methods under development. Prevention strategies are discussed in a closing section. PMID:1633658

  9. [Contraception in adolescents].

    PubMed

    Rey-Stocker, I

    1977-06-01

    Contraception for adolescents should be considered an important part of prophylactic medicine. Not enough attention has been given to this area, which could mean saving a young person from the destruction of his or her plans, and disruption of their family with an unwanted, unexpected child. This involves greater rapport with adolescents in schools on matters of sexual awareness and education. Noting that 15% of pregnancies between the ages of 12 and 16 are on the first sexual contact, the morning after pill and post coital progestins are thought appropriate as they require only single uses. The most frequently used methods are coitus interruptus (36%), followed by the male condom with vaginalspermicides, and the diaphragm. The use of hormonal contraceptives by adolescents raises questions about their effects on the development of the hypothalamal-hypophysial-ovarian system and the growth of the uterus. The use of intrauterine devices is generally countraindicated, as the uterus grows about 6 cm a month during adolescence and the action of these devices can have dangerous effects on this growth. PMID:905711

  10. [Male contraception and vasectomy].

    PubMed

    Emperaire, J C; Audebert, A; Mattei, A

    1977-01-01

    This review summarized the regulation of testicular function and the theoretical aspects subject to male contraception, lists and tabulates steroids effective in inhibiting spermatogenesis, and evaluates vasectomy in the light of the fact that no method is entirely effective, acceptable, and reversible. Possible male contraceptive techniques include hypothalamic agents such as MAO inhibitors, biogenic amines that inhibit releasing hormones, hydrazines, reserpine, analogs of luteinizing hormone-releasing hormone, drugs acting on the testis such as ethylenimine, colchicine, chlormmphenicol, prednisolone; and substances acting on sperm maturation, e.g., heavy metals, alpha-chlorohydrins. Most of these are toxic or teratologic. Testosterone in low doses inhibits spermatogenesis and testicular volume, at high doses maintains testicular volume, produces azoospermia, but has several unacceptable side effects like increasing beta-lipoporteins. Other androgens must be combined with testosterone. Estrogens cause loss of libido. Progestagens are effective, and some are metabolized into androgens. Ethinyl testerone (Danazol) and Cyproterone acetate both depress libido so they must be combined with testosterone. The most inconvenient drawback of these drugs is that several sperm counts must be done to ensure azoospermia. Vasectomy as the advantage of being simple, effective, and without any great risk, although it should be considered irreversible, and is not popular in France. PMID:12260083

  11. Contraceptive sponge discontinued.

    PubMed

    1995-03-01

    The vaginal sponge, an over-the-counter spermicidal contraceptive, will no longer be available to US women. Whitehall-Robins Healthcare, which began manufacturing the sponge in 1983, has ceased manufacturing this product allegedly because of stringent Food and Drug Administration (FDA) requirements. The FDA had found bacterial contamination in the air at the company plant and challenged the purity of water used, but did not oppose continued production of the sponge under hygienic conditions. Company officials maintained that testing and manufacturing upgrading would require extensive modifications in the plant, in turn necessitating price increases that would curtail sponge sales. No consumer complaints about the product were received. By 1993, the vaginal sponge had captured 29% of the market for over-the-counter contraceptives. Its advantages included insertion up to 24 hours before sexual intercourse and use for repeated sexual activity within a 24-hour period. Family planning workers have expressed concern about the decision to cease manufacture of the sponge since it was frequently selected by older adolescents due to its easy accessibility. PMID:12288786

  12. Medicinal plants: conception / contraception.

    PubMed

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

    1994-01-01

    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

  13. Interpersonal communication and contraception: Insights and evidences from Bangladesh demographic and health survey, 2011.

    PubMed

    Raut, Manoj Kumar

    2015-01-01

    This paper examines the role of exposure to mass media and interpersonal communication in predicting the current use of contraception in Bangladesh. Bivariate and multivariate analyses were carried out using the Bangladesh Demographic and Health Survey (BDHS), 2011 data to explore the association between communication and the current use of contraception. After adjusting the related socioeconomic and demographic factors, the mass media did not seem to have any role in predicting contraceptive use behavior while the findings revealed that interpersonal communication [prevalence ratio (PR): 1.0984, 95% confidence interval (CI) 1.0801-1.1170] is a strong positive predictor of the current contraceptive use. It is a well-known fact that mass media performs only the knowledge function while interpersonal communication performs an additional function of persuasion. This analysis corroborates the statement that the role of interpersonal communication is quite important in predicting contraceptive use. PMID:26354400

  14. A qualitative study of clandestine contraceptive use in urban Mali.

    PubMed

    Castle, S; Konaté, M K; Ulin, P R; Martin, S

    1999-09-01

    This prospective study uses qualitative methods to examine the social and economic impact of family planning on women's lives in the district of Bamako, Mali. Fifty-five first-time users of contraceptives were interviewed in October 1996. Of particular interest is the high proportion (17/55) of those who had hidden their use of a birth-control method from their husbands. Substantial collusion is found to have occurred between sisters-in-law in assisting each other to gain and hide methods of family planning and to keep their use secret from their spouses and older marital relatives. The main reason for discontinuation among the clandestine users was menstrual disruption, which they feared would make their husbands aware of their contraceptive use. By the end of the study, women were aware that their use of contraceptives had increased their mobility and available time, enabling them to enhance the quantity and efficiency of their work activities. Contraception, therefore, appears to be a valuable resource, permitting women to improve their economic and social status. In settings where clandestine use is prevalent, at least in the short term involving men in family planning programs may not always be beneficial, nor may considering the couple as the unit of intervention and analysis always be appropriate. In the long term, however, the underlying causes of men's objections to contraceptive use need to be addressed so as to facilitate communication and joint decisionmaking about family planning. PMID:10546314

  15. Rheumatoid arthritis, the contraceptive pill, and androgens.

    PubMed Central

    James, W H

    1993-01-01

    Evidence is accumulating that low androgen concentrations are a cause of rheumatoid arthritis. This would explain a number of established features of the epidemiology of the disease. These include: (a) the variation of disease activity with pregnancy; (b) the variation of age at onset by sex; (c) the variation by sex with HLA-B15; (d) the association with bone mineral density; and (e) the differing time trends in incidence rates by sex. It is argued, moreover, that if one makes a plausible assumption--namely, that women who choose oral contraceptives have high androgen concentrations at the time they first make this choice--then an explanation becomes available for the confusion about the relation between rheumatoid arthritis and oral contraception. Grounds are adduced for that assumption. If this line of reasoning is substantially correct it also has implications for the relations between rheumatoid arthritis and smoking and consumption of alcohol. PMID:8323402

  16. New contraceptives in the 1990s.

    PubMed

    O'Connell, B J

    1995-08-01

    This article reviews the contraceptive methods levonorgestrel implants and depot medroxyprogesterone acetate. These methods provide effective and safe contraception for adolescents and adults. This review focuses on the use of these contraceptive techniques in the adolescent population, discussing patient selection, side effects, and controversies concerning the methods. Future hormonal contraceptive methods are also discussed. PMID:7581638

  17. Change Rates and Prevalence of a Dichotomous Variable: Simulations and Applications

    PubMed Central

    Brinks, Ralph; Landwehr, Sandra

    2015-01-01

    A common modelling approach in public health and epidemiology divides the population under study into compartments containing persons that share the same status. Here we consider a three-state model with the compartments: A, B and Dead. States A and B may be the states of any dichotomous variable, for example, Healthy and Ill, respectively. The transitions between the states are described by change rates, which depend on calendar time and on age. So far, a rigorous mathematical calculation of the prevalence of property B has been difficult, which has limited the use of the model in epidemiology and public health. We develop a partial differential equation (PDE) that simplifies the use of the three-state model. To demonstrate the validity of the PDE, it is applied to two simulation studies, one about a hypothetical chronic disease and one about dementia in Germany. In two further applications, the PDE may provide insights into smoking behaviour of males in Germany and the knowledge about the ovulatory cycle in Egyptian women. PMID:25749133

  18. [Historical survey of modern reversible contraceptive methods].

    PubMed

    Mbabajende, V

    1986-04-01

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

  19. Extraspinal Incidental Findings on Routine MRI of Lumbar Spine: Prevalence and Reporting Rates in 1278 Patients

    PubMed Central

    agl?, Bekir; Tekata?, Aslan; K?r?c?, Mehmet Yadigar; nl, Ercment; Genhella, Hakan

    2015-01-01

    Objective The aim of the present study was to determine the prevalence and reporting rate of incidental findings (IF) in adult outpatients undergoing lumbar magnetic resonance imaging (MRI). Materials and Methods Re-evaluation of a total of 1278 lumbar MRI images (collected from patients with a mean age of 50.5 years, range 16-91 years) captured between August 2010-August 2011 was done by a neuroradiologist and a musculoskeletal radiologist. IFs were classified according to organ or system (liver, gallbladder, kidney, bladder, uterus, ovary, lymph node, intestine and aorta). The rate of reporting of a range of IF was examined. The outcome of each patient's treatment was evaluated based on review of hospital records and by telephone interviews. Results A total of 253 IFs were found in 241 patients (18.8% of 1278). Among these, clinically significant IFs (n = 34) included: 2 renal masses (0.15%), 2 aortic aneurysms (0.15%), 2 cases of hydronephrosis (0.15%), 11 adrenal masses (0.86%), 7 lymphadenopathies (0.55%), 6 cases of endometrial or cervical thickening (0.47%), 1 liver hemangioma (0.08%), 1 pelvic fluid (0.08%) and 2 ovarian dermoid cysts (0.15%). Overall, 28% (71/253) of IFs were included in the clinical reports, while clinically significant findings were reported in 41% (14/34) of cases. Conclusion Extraspinal IFs are commonly detected during a routine lumbar MRI, and many of these findings are not clinically significant. However, IFs including clinically important findings are occasionally omitted from formal radiological reports. PMID:26175587

  20. 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

    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

    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

  1. Identical twinning and oral contraception.

    PubMed

    Emery, A E

    1986-03-01

    Twinning rates for like-sexed and unlike-sexed twins for each year from 1952 to 1983--obtained from the Registrar General's Birth Statistics for England and Wales and the Annual Reports for Scotland--refer to the number of live and still births per 1000 maternities. Non-identical, fraternal or dizygous (DZ) twins are derived from the independent release and subsequent fertilization of 2 separate ova; identical or monozygous (MZ) twins are derived from the splitting of a single fertilized ovum at an early stage in development. Since the 1950s, there has been a definite decline in the incidence of DZ twins; the MZ twinning rate may have started to increase in the 1960s but certainly by the early 1970s, and it is still continuing. Changes in MZ twinning rates may be related to the use of oral contraceptives (OC). A recent study involving 1000 multiple Australian births shows that significantly more MZ twins occur in pregnancies which take place shortly after ceasing OCs compared with pregnancies in non-users. In conceptions which follow soon after the cessation of OCs, or by the unintentional use of OCs in early pregnancy, the resultant changes in the fallopian tubes or endometrium may delay implantation of the fertilized ovum so that early division occurs, resulting in 2 embryos. PMID:12280444

  2. Pharmacokinetic and pharmacodynamic drug interactions between antiretrovirals and oral contraceptives.

    PubMed

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

    2015-01-01

    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

  3. [Place of intrauterine devices in contraception (author's transl)].

    PubMed

    Levrier, M; Roux, G

    1981-08-01

    The authors of this article attempt to give a general picture of IUD contraception worldwide, a rather difficult task, since data and available statistics are often nonexistent or unreliable. The majority of information on IUD use is collected by the French INED (Institut National d'Etudes Economiques), and by USAID. Of the about 200 million women practicing contraception, 50-60 million use an IUD. In industrialized countries IUD use is slowly replacing OC (oral contraception), especially since 1975. IUD users are generally over 35, educated, and with at least 1 child. In Europe the highest percentage of IUD users is to be found in Scandinavian countries with 20%, followed by France with 11%, down to Spain with 2%. In Japan only 9% of contraception seekers use the IUD, and in the U.S. only 6%. Retention rate for IUD users is high. The majority of family planning programs in developing countries offer intrauterine contraception, but clash against moral or ideological resistances, as in catholic Latin America, with the notable exceptions of Chile, Columbia and Paraguay, or in Islamic Asia or Africa. In India, where the majority of the population lives in rural areas, sterilization is still more popular than IUD use, while in China 25% of contraception users choose the IUD. In recent years the intrauterine method of contraception has been further perfected due to the utilization of better materials and to a better knowledge of uterine physiology. Immediate reversibility and absence of constraints are still the best advantages of IUD contraception. PMID:12263336

  4. Women's knowledge of emergency contraception.

    PubMed

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

    1994-10-01

    To assess women's knowledge of postcoital contraceptive methods, a questionnaire was distributed to 1290 women 16-50 years of age located at 14 general practice surgeries in London, England, in 1990. 690 (78.6%) of the 878 women whose questionnaires were returned and suitable for analysis had heard of postcoital contraception. Affirmative responses were greater among users of barrier methods and increased linearly with educational level. Of those who had heard of emergency contraception, 434 (64%.0%) knew it could be used after unexpected sex and 420 (61.9%) cited sexual assault as an indicator; only 286 (42.2%) were aware it could be used as a back-up when another contraceptive method had failed. Only 92 (13.6%) respondents gave the correct 72-hour time frame for the effective use of postcoital contraception. Overall, the survey findings indicated widespread awareness as to the availability of postcoital contraception but a lack of accurate knowledge concerning its proper use. Of the 690 women who answered the question on knowledge sources, 51.6% cited the mass media, 23.5% identified friends and relatives, and only 20.1% had been informed by a health care professional. It is recommended that primary health care staff incorporate counseling on emergency contraception--especially its use as a back-up method in cases of condom or diaphragm failure--into consultations on fertility control and safe sex. PMID:7748633

  5. Preventing Unintended Pregnancy: The Contraceptive CHOICE Project in Review.

    PubMed

    Birgisson, Natalia E; Zhao, Qiuhong; Secura, Gina M; Madden, Tessa; Peipert, Jeffrey F

    2015-05-01

    The Contraceptive CHOICE Project (CHOICE) sought to reduce unintended pregnancies in the St. Louis Region by removing cost, education, and access barriers to highly effective contraception. CHOICE was a prospective cohort study of over 9,000 women 14-45 years of age who received tiered contraceptive counseling to increase awareness of all reversible methods available, particularly long-acting reversible contraceptive (LARC) methods. Participants were provided with contraception of their choice at no cost for 2-3 years. We studied contraceptive method choice, continuation, and population outcomes of repeat abortion and teen pregnancy. Seventy-five percent of study participants chose one of the three LARC methods (46% levonorgestrel intrauterine system, 12% copper intrauterine device, and 17% subdermal implant). LARC users reported greater continuation than non-LARC users at 12 months (87% versus 57%) and 24 months (77% versus 41%). In our cohort, LARC methods were 20 times more effective than non-LARC methods. As a result, we observed a reduction in the percent of repeat abortions from 2006 to 2010 in St. Louis compared with Kansas City and nonmetropolitan Missouri and found substantial reductions in teen pregnancy, birth, and abortion (34.0, 19.4, and 9.7 per 1000 teens, respectively) compared with national rates among sexually experienced teens (158.5, 94.0, and 41.5 per 1000, respectively). Improved access to LARC methods can result in fewer unintended pregnancies and abortions and considerable cost savings to the health care system. PMID:25825986

  6. Does contraceptive use always reduce breast-feeding?

    PubMed

    Jayachandran, Seema

    2014-06-01

    Previous studies suggest that access to modern contraceptives can reduce breast-feeding rates because women who had been using breast-feeding to avoid pregnancy substitute away from it. This article shows that contraceptive use can also have a positive effect on breast-feeding. A mother often weans a child if she becomes pregnant again, which can occur sooner than desired if she lacks access to contraceptives. Thus, by enabling longer birth spacing and preventing unwanted pregnancies, contraceptive use allows for a longer duration of breast-feeding. This positive effect should primarily affect infants who are past the first few months of life because their mothers are more fecund then, and the negative effect should affect infants who are very young because the contraceptive property of breast-feeding is strongest then. I test for these dual effects using Demographic and Health Survey data for Indonesia. I find evidence of the positive birth-spacing effect: contraceptive use increases the likelihood that children continue to be breast-fed past age 1. There is also suggestive evidence of a negative substitution effect among infants age 3 months and younger. PMID:24659090

  7. Preventing Unintended Pregnancy: The Contraceptive CHOICE Project in Review

    PubMed Central

    Birgisson, Natalia E.; Zhao, Qiuhong; Secura, Gina M.; Madden, Tessa

    2015-01-01

    Abstract The Contraceptive CHOICE Project (CHOICE) sought to reduce unintended pregnancies in the St. Louis Region by removing cost, education, and access barriers to highly effective contraception. CHOICE was a prospective cohort study of over 9,000 women 14–45 years of age who received tiered contraceptive counseling to increase awareness of all reversible methods available, particularly long-acting reversible contraceptive (LARC) methods. Participants were provided with contraception of their choice at no cost for 2–3 years. We studied contraceptive method choice, continuation, and population outcomes of repeat abortion and teen pregnancy. Seventy-five percent of study participants chose one of the three LARC methods (46% levonorgestrel intrauterine system, 12% copper intrauterine device, and 17% subdermal implant). LARC users reported greater continuation than non-LARC users at 12 months (87% versus 57%) and 24 months (77% versus 41%). In our cohort, LARC methods were 20 times more effective than non-LARC methods. As a result, we observed a reduction in the percent of repeat abortions from 2006 to 2010 in St. Louis compared with Kansas City and nonmetropolitan Missouri and found substantial reductions in teen pregnancy, birth, and abortion (34.0, 19.4, and 9.7 per 1000 teens, respectively) compared with national rates among sexually experienced teens (158.5, 94.0, and 41.5 per 1000, respectively). Improved access to LARC methods can result in fewer unintended pregnancies and abortions and considerable cost savings to the health care system. PMID:25825986

  8. [Mental changes in women due to the use of hormonal contraception].

    PubMed

    Ottová, B; Weiss, P

    2015-10-01

    The study investigates physical, mental and sexual changes in women at the beginning of use or after discontinuation of a combined hormonal contraception. Thirty women were interviewed at least 3 months and at most 2 years after the start of use or discontinuation of combined hormonal contraception. Semi-structured interviews were supplemented by 16-symptom rating scale on which women assessed the results of an imaginary study of side effects of hormonal contraception. Both methods identically demonstrated pronounced effect of combined hormonal contraception on decline in sexual desire and painful menstruation. No clear difference was found in psychical symptoms, although qualitative analysis indicated possible changes. PMID:26606121

  9. Safety and Efficacy of Contraceptive Methods for Obese and Overweight Women.

    PubMed

    Lotke, Pamela S; Kaneshiro, Bliss

    2015-12-01

    Increasing rates of obesity have become a major public health challenge. Given the added health risks that obese women have during pregnancy, preventing unwanted pregnancy is imperative. Clinicians who provide contraception must understand the efficacy, risks, and the weight changes associated with various contraceptive methods. Despite differences in the pharmacokinetics and pharmacodynamics of hormonal contraceptives in overweight and obese women, efficacy does not appear to be severely impacted. Both estrogen-containing contraceptives and obesity increase the risk of venous thromboembolism, but the absolute risk remains acceptably low in reproductive age women. PMID:26598306

  10. Adolescent use of oral contraceptives.

    PubMed

    Babington, M A

    1984-01-01

    By age 16, 1/4 of all unmarried women have had at least 1 sexual experience, and 1/5 of American births are to teenagers. Of these 2/3 are unintended. Teenage pregnancies are associated with infant mortality rates 2-3 times those of the general population and maternal mortality 60% higher than that for young adult women. Early termination of school is another hazard of adolescent pregnancy. The ideal adolescent candidate for oral contraceptives (OCs) is one who has intercourse somewhat frequently, has no medical contraindications to OCs, has established regular menses, and complies with her medication schedule. 2 major types of OCs are available: the combined containing an estrogen and a progestogen for 21 days of the cycle, and the minipill containing only .35 mg of norethindrone, a progestogen. The minipill exerts its effects primarily peripherally and would not be a good choice for an adolescent because the failure rate is 2.54/100 woman-years with the rate greatly increasing when a single dose is missed. The side effects of OCs are caused by hormonal excess or deficiency, allowing the contraceptive provider to choose the agent based on the woman's response to the side effects. If the side effects are not too severe, a 3-month trial should be allowed prior to switching agents since most side effects related to hormone dose decrease in severity with time. Adverse effects in general are seen more frequently in women over 35 and depend in part on behavioral habits such as smoking and drinking as well as underlying disease states such as diabetes or hypertension. Most reported adverse effects were reported from longterm follow-up studies begun in the 1960s and 1970s, when OCs contained higher doses of estrogens. Some important drug interactions may occur but are probably of limited relevance to adolescents. Adolescent compliance with OCs, necessary for their full effectiveness to be gained, can be increased by providing a feeling of privacy and confidentiality in the counseling area, establishing a mutual relationship between the provider and user, using terminology the adolescent can understand, encouraging the adolescent to ask questions and give feedback, and providing detailed instructions. Instructions should be provided for missed doses, lost pills, and self-discontinuation of medication. PMID:6561506

  11. THE INFLUENCE OF SOURCES OF INFORMATION ON CONTRACEPTION USE IN GEORGIA.

    PubMed

    Japaridze, T; Kristesashvili, J; Imnadze, P

    2015-11-01

    Along with socio-economic, cultural-traditional and other factors reliability of sources of information have an important influence on contraception use decision-making. The aims of study were to determine the significant sources of information about contraceptive methods and their influence on contraception use in Georgia. Secondary data analysis of women reproductive health survey 2010 was done. Descriptive statistics and multinomial logistic regression was used to establish statistically significant association of reliable sources of information with contraceptive methods use for selected group of women (n=4487). Friends frequently source of information about contraception, could not influence on contraception use decision (p>0.05). A reliable source of information are doctors, along with husband or partner. Doctors have an impact on modern, effective contraception choice (pill: OR =9.040, 95%CI 2.148-38.049 P=0.003, IUD: OR =14.248, 95%CI 1.886-107.664 P=0.010)) and on traditional methods (withdrawal, rhythm/calendar) choice as well (p<0.05). Information obtained from men/partner are associated with male condom use (OR =6.553, 95%CI 2.958-14.518 P=0.000 and traditional methods (withdrawal) use too (p<0.05). Since women consider doctors as a reliable source of information and information obtained from them influence on contraception use, it is necessary to improve doctors' knowledge about modern methods of contraception, acquiring necessary skills for conducting good counseling and work with pairs to help women to make well informed decision about high effective contraceptive choice. That increase modern effective contraception use prevalence and decrease the number of unintended pregnancies. PMID:26656545

  12. The Effect of Integrating Family Planning with a Maternal and Newborn Health Program on Postpartum Contraceptive Use and Optimal Birth Spacing in Rural Bangladesh.

    PubMed

    Ahmed, Saifuddin; Ahmed, Salahuddin; McKaig, Catharine; Begum, Nazma; Mungia, Jaime; Norton, Maureen; Baqui, Abdullah H

    2015-09-01

    Meeting postpartum contraceptive need remains a major challenge in developing countries, where the majority of women deliver at home. Using a quasi-experimental trial design, we examine the effect of integrating family planning (FP) with a community-based maternal and newborn health (MNH) program on improving postpartum contraceptive use and reducing short birth intervals <24 months. In this two-arm trial, community health workers (CHWs) provided integrated FP counseling and services during home visits along with their outreach MNH activities in the intervention arm, but provided only MNH services in the control arm. The contraceptive prevalence rate (CPR) in the intervention arm was 15 percent higher than in the control arm at 12 months, and the difference in CPRs remained statistically significant throughout the 24 months of observation. The short birth interval of less than 24 months was significantly lower in the intervention arm. The study demonstrates that it is feasible and effective to integrate FP services into a community-based MNH care program for improving postpartum contraceptive use and lengthening birth intervals. PMID:26347092

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

    ERIC Educational Resources Information Center

    du Plessis, Karin; Corney, Tim

    2011-01-01

    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

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

    ERIC Educational Resources Information Center

    du Plessis, Karin; Corney, Tim

    2011-01-01

    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…

  15. How Variable Are Interstate Prevalence Rates of Learning Disabilities and Other Special Education Categories? A Longitudinal Comparison

    ERIC Educational Resources Information Center

    Hallahan, Daniel P.; Keller, Clayton E.; Martinez, Elizabeth A.; Byrd, E. Stephen; Gelman, Jennifer A.; Fan, Xitao

    2007-01-01

    This study compared interstate variability of prevalence rates for special education categories from 1984 to 1985 through 2001 to 2002, using the coefficient of variation (CV), which is designed to compare variances when the means of the groups compared are radically different. The category of learning disabilities, presumed by many to be the most

  16. Temporal Trends and Predictors of Modern Contraceptive Use in Lusaka, Zambia, 2004–2011

    PubMed Central

    Hancock, Nancy L.; Chibwesha, Carla J.; Stoner, Marie C. D.; Vwalika, Bellington; Rathod, Sujit D.; Kasaro, Margaret Phiri; Stringer, Elizabeth M.; Stringer, Jeffrey S. A.; Chi, Benjamin H.

    2015-01-01

    Introduction. Although increasing access to family planning has been an important part of the global development agenda, millions of women continue to face unmet need for contraception. Materials and Methods. We analyzed data from a repeated cross-sectional community survey conducted in Lusaka, Zambia, over an eight-year period. We described prevalence of modern contraceptive use, including long-acting reversible contraception (LARC), among female heads of household aged 16–50 years. We also identified predictors of LARC versus short-term contraceptive use among women using modern methods. Results and Discussion. Twelve survey rounds were completed between November 2004 and September 2011. Among 29,476 eligible respondents, 17,605 (60%) reported using modern contraception. Oral contraceptive pills remained the most popular method over time, but use of LARC increased significantly, from less than 1% in 2004 to 9% by 2011 (p < 0.001). Younger women (OR: 0.46, 95% CI: 0.34, 0.61) and women with lower levels of education (OR: 0.70, 95% CI: 0.56, 0.89) were less likely to report LARC use compared to women using short-term modern methods. Conclusions. Population-based assessments of contraceptive use over time can guide programs and policies. To achieve reproductive health equity and reduce unmet contraceptive need, future efforts to increase LARC use should focus on young women and those with less education. PMID:26819951

  17. The social marketing of contraceptives in Mexico.

    PubMed

    De La Macorra, L

    1980-07-01

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

  18. Tunisia: rural contraceptive distribution project has impact.

    PubMed

    1979-10-01

    The Tunisian National Development Plan calls for a 40% reduction in the annual growth rate by the year 2000. The Office National du Planning Familial et de la Population (ONPFP) aims, within the next 5 years, to make the delivery of contraceptive information and services more efficient and more widespread throughout the rural areas of the country. A pilot project, the Planning Familial a Domicile (PFAD), which was launched in 1976 demonstrated the feasibility of moving from the traditional clinic-based family planning program to a door-to-door contraceptive distribution system. After 2 years of intensive household distribution within the target area by nonmedical personnel, contraceptive use had increased from 6.6% to 17.7%, an increase of 168%. The success of this pilot project has led the ONPFP to institute further family planning extension services throughout the rural areas of the country. 2 current household distribution projects have grown out of the PFAD experience. These are designed to test the feasibility of integrated delivery of family planning and maternal/child health services. An additional program, the Planning Familial en Milieu Rural (PFMR), is assessing the effectiveness and cost-effectiveness of using mobile clinics and social assistants for family planning work. PMID:12261373

  19. [Contraception, abortion and sexually transmitted diseases].

    PubMed

    Nesheim, B I

    1992-02-28

    Contraceptives that protect against pregnancy tend to offer the least protection against sexually transmitted diseases (STDs), particularly needed by young people who change partners frequently. Oral contraceptive (OCs) protect best against pregnancy and salpingitis, but they do not protect against infections of the cervix; thus, there is a higher incidence of Chlamydia trachomatis and Neisseria gonorrhea among OC users. The IUD is also very effective, but there is an elevated risk of infections during the first 20 days after fitting, as bacteria may move up to the uterus from the cervical canal during insertion. The effectiveness of the condom depends on the users, and studies show that when used consistently it provides significant protection against STDs. The diaphragm also protects against STDs, but it is insignificant from a quantitative point of view. In Norway, in 1977, 30% of 18-19 year old women used OCs, and 21% used IUDs. In contrast, in 1988, 65% of 20-year old women used OCs and 5% used IUDs. Condom use remains unchanged. The rate of abortion has not changed since 1977; it is highest among women aged 18-29 (about 30/1000 women per year), although safe contraception use has increased from 50% to 70% among women aged 18-19. Free-service health clinics with evening hours have met a clear need for counseling in the past 20 years. In the 1970s the demand was high for induced abortion, safe contraceptives, and IUD insertion. Later, OCs had lower hormone content and fewer site effects, and their dispensation became more widespread among general practitioners. Nowadays a large proportion of women seek advice on STDs, and 65% of them attend because the consultation is free. It is an important task of these clinics to provide guidance, examination, and treatment to high-risk people to help them avoid STDs and unwanted pregnancy. PMID:1561591

  20. Nomegestrol acetate/estradiol: in oral contraception.

    PubMed

    Yang, Lily P H; Plosker, Greg L

    2012-10-01

    Nomegestrol acetate/estradiol is a combined oral contraceptive with approval in many countries. This fixed-dose combination tablet contains nomegestrol acetate, a highly selective progestogen, and estradiol, a natural estrogen. It is the first monophasic combined oral contraceptive to contain estradiol, and is taken in 28-day cycles, consisting of 24 active therapy days with 4 placebo days (i.e. 24/4-day cycles). In two large, 1-year, randomized, open-label, multicentre, phase III trials in healthy adult women (aged 18-50 years), nomegestrol acetate/estradiol was at least as effective as drospirenone/ethinylestradiol as contraceptive therapy, as the pregnancy rates in women aged 18-35 years (primary efficacy population) in terms of the Pearl Index (primary endpoint) were numerically lower with nomegestrol acetate/estradiol, although the between-group difference was not statistically significant. In both trials, nomegestrol acetate/estradiol was given in a 24/4-day cycle, and drospirenone/ethinylestradiol was given in a 21/7-day cycle. The criteria for using condoms in case of forgotten doses were less stringent in the nomegestrol acetate/estradiol group than in the drospirenone/ethinylestradiol group. Nomegestrol acetate/estradiol therapy for up to 1 year was generally well tolerated in healthy adult women, with an acceptable tolerability profile in line with that expected for a combined oral contraceptive. The most commonly reported adverse events were acne and abnormal withdrawal bleeding (most often shorter, lighter or absent periods). Overall, compared with drospirenone/ethinylestradiol, nomegestrol acetate/estradiol appeared to be associated with less favourable acne-related outcomes, and shorter, lighter or absent periods. PMID:22950535

  1. Emerging Options for Emergency Contraception

    PubMed Central

    Koyama, Atsuko; Hagopian, Laura; Linden, Judith

    2013-01-01

    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

  2. FastStats: Contraceptive Use

    MedlinePlus

    ... Population Sex Men's Health Women's Health State and Territorial Data Reproductive Health Contraceptive Use Infertility Obstetrical Procedures ... Family Growth [PDF - 3.4 MB] Fertility, Family Planning, and Reproductive Health of U.S. Women: Data from ...

  3. Progestin-Only Oral Contraceptives

    MedlinePlus

    ... If you have had a miscarriage or an abortion, you can start taking progestin-only oral contraceptives ... medication may interfere with some laboratory tests.Rarely, women can become pregnant even if they are taking ...

  4. How Effective Is Male Contraception?

    MedlinePlus

    ... men, methods of contraception include male condoms and sterilization (vasectomy). Male condoms. This condom is a thin ... it is not always possible. Vasectomy, like other sterilization procedures, is considered a permanent form of birth ...

  5. Contraception in the adolescent patient.

    PubMed

    Tafelski, T; Boehm, K E

    1995-03-01

    Having presented an overview of the available methods of contraception, the authors present one approach to prescribing contraceptives based on their experience. First, adolescent patients in our practice are discouraged from engaging in sexual intercourse. Abstinence is the only fail-safe method of contraception and provides benefits both emotionally and physically (i.e., prevention from sexually transmitted diseases and unwanted pregnancies). If the adolescent plans to be sexually active, however, she is encouraged to select some form of hormonal contraception, namely Norplant, Depo-Provera, or oral contraceptives, in conjunction with condoms. The authors have had little success recommending barrier methods alone. Condoms are used sporadically and the diaphragm is very awkward for adolescents who are still uncomfortable with their bodies and with touching themselves. Of the three hormonal methods, Depo-Provera seems to be well-accepted by our patients. It offers several advantages that we believe make it attractive. First, it does not require any forethought by the patient other than coming in for the injection every 3 months. There is an effective grace period, so the patient is afforded good contraception even if she is up to a month late for her injection. The frequent visits for injections actually can be looked upon as positive, frequent contacts with the patient and can provide opportunities for counseling. In addition, some patients become amenorrheic, which teens view as an advantage, increasing compliance. If it is not likely that a patient will be compliant with every-3-month injections, Norplant is recommended. Studies have shown good acceptance of Norplant by adolescents and that has been the experience of the authors. With appropriate counseling prior to insertion and a counseling session with patients who request removal, the number of actual Norplant removals has been limited. If Depo-Provera and Norplant are not acceptable to the patient, then oral contraceptives are recommended. Of the three methods, more opportunities for failure exist with oral contraceptives. Pills are missed for a variety of reasons, including going away for the weekend; not having a regular schedule, which can interrupt pill-taking; and even ambivalence about becoming pregnant. One recent study demonstrated certain patient characteristics that were associated with good compliance with oral contraceptives, including white race, higher education level, suburban residence, and older age of both the patient and her mate. Keeping these characteristics in mind may be helpful when prescribing oral contraceptives. Of course, it is the patient's prerogative to choose the type of contraception she feels will be best suited for her.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:7777635

  6. Effect of contraceptives on the skin.

    PubMed

    1988-10-01

    Combined oral contraceptives (COCs) affect the skin 3 different ways. They decrease the amount of androgenic hormones produced in the ovaries and adrenal gland. They also limit the quantity of biologically active circulating testosterone. Finally, estrogen markedly decreases oil production in the sebaceous glands. Physicians should prescribe to women with acne a COC that is low in progestogen and high in estrogen. A biphasic pill with no more than 500 mcg norethisterone/day meets these requirements. If a woman is taking systemic antibiotics to treat acne, however, the physician should prescribe a biphasic pill containing 50 mcg ethinyl estradiol. Even though many believe that using COCs causes hair loss, there is little evidence to support it. Nevertheless, if a woman has indeed experienced hair loss, she should take a COC with a high estrogen to progestogen ratio. As in some pregnant women, cholasma may occur in women taking COCs when not protected from sunlight. Physicians need to prescribe the lowest possible dose of hormones in these women and counsel them to shield their face from sunlight. To err on the side of safety, women who have had a malignant melanoma should not use a hormonal contraceptive. In addition, women who have experienced many bouts of skin candidiasis should use an alternative contraceptive. Other skin disorders that they have been found to be more prevalent in women taking COCs include erythema nodosum, accelerated systemic lupus erythematosus, porphyria cutanea tarda, herpes gestationis, spider naevus, and telangiectasia. There also exists an association between dermatitis and barrier methods and spermicides. Some articles have suggested that copper containing IUDs have also cause a variety of skin disorders. PMID:3240155

  7. Non-use of contraception: determinants among Ugandan university students

    PubMed Central

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

    2012-01-01

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

    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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

    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…

  10. [Oral contraceptives: knowledge and compliance].

    PubMed

    Koch, T; Marslew, U; Nielsen, M R

    1993-11-01

    One hundred and twenty (120) women, taking contraceptive pills, underwent a structured interview with a view elucidating their knowledge of the physiology of menstruation, the action and side effects of contraceptive pills and their compliance in the taking of contraceptive pills. The most important sources of information were the medical letters in magazines and the women's own doctors, while the teaching in the Folkeskole (primary and lower secondary school) had not had any major influence on the level of information. Well over one third of the interviewed women knew the most important action mechanism of the contraceptive pill, and half of the women could give a satisfactory explanation of the physiology of menstruation. Twenty-four percent (24%) thought that pregnancy could not occur until 1-2 months after the woman had ceased taking the pill. There was high compliance among the women i.e. that their behavior was correct when they had forgotten to take one or two contraceptive pills, when bleeding was irregular, and when beginning on a new package of pills. Eighty-three percent (83%) had experienced side effects that could be related to contraceptive pills. The investigation shows that there is a need for more efficient information about the effects of the Pill and about the physiology of menstruation. PMID:8236575

  11. Oral contraceptives and cervical neoplasia.

    PubMed

    Brinton, L A

    1991-06-01

    Although initial studies examining the relationship of oral contraceptives to risk of cervical neoplasia were reassuring, more recent studies provide some evidence of a positive relationship, particularly for long-term usage. Results, however, are difficult to interpret, because of a variety of methodologic complexities, including potential sources of confounding and bias. Sexual behavior and Pap smear screening have been identified as important confounders, but in several well-controlled studies residual excess risks of nearly 2-fold persist for users of 5 or more years. A possible promotional effect of oral contraceptives is suggested by higher risks associated with recent usage. There also is some suggestion of a stronger effect for adenocarcinomas than for squamous cell tumors. A relationship is biologically possible, given findings of hormone receptors in cervical tissue and the fact that oral contraceptives have been found to induce cervical hyperplasia. In addition, oral contraceptives may induce proliferation of the human papillomaviruses, the leading suspect agent for cervical cancer. Although a number of lines of evidence support a relationship of oral contraceptives to cervical cancer risk, firm conclusions await the results of additional studies that specifically address some of the methodologic shortcomings of previous investigations. In particular, additional follow-up studies are needed to define the effect of oral contraceptives on the natural history of cervical lesions. PMID:1868734

  12. Beyond the Condom: Frontiers in Male Contraception.

    PubMed

    Roth, Mara Y; Amory, John K

    2016-05-01

    Nearly half of all pregnancies worldwide are unplanned, despite numerous contraceptive options available. No new contraceptive method has been developed for men since the invention of condom. Nevertheless, more than 25% of contraception worldwide relies on male methods. Therefore, novel effective methods of male contraception are of interest. Herein we review the physiologic basis for both male hormonal and nonhormonal methods of contraception. We review the history of male hormonal contraception development, current hormonal agents in development, as well as the potential risks and benefits of male hormonal contraception options for men. Nonhormonal methods reviewed will include both pharmacological and mechanical approaches in development, with specific focus on methods which inhibit the testicular retinoic acid synthesis and action. Multiple hormonal and nonhormonal methods of male contraception are in the drug development pathway, with the hope that a reversible, reliable, safe method of male contraception will be available to couples in the not too distant future. PMID:26947703

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

    PubMed Central

    2014-01-01

    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

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

    PubMed Central

    2012-01-01

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

  15. [Ignorance and misconceptions in the use of contraceptive methods].

    PubMed

    Nafo, F; Wollast, E; Serniclaes, W; Vekemans, M

    1993-09-01

    Good knowledge of the available contraceptive methods ensures better acceptability, continuity and satisfaction, and lower failure rates of these methods. This paper describes an inquiry on the contraceptive knowledge in 114 women attending three Brussels family planning clinics. Misconceptions, beliefs in false rumors, and considerable insufficiencies in knowledge were detected. In order to increase patient's ability to correctly use birth control methods, so as to lower unwanted pregnancy rate, efforts should be made by health practitioners as well as by mass media and teaching institutions. PMID:8235186

  16. Effect of supply source on oral contraceptive use in Mexico.

    PubMed

    Bailey, J; Jimenez, R A; Warren, C W

    1982-11-01

    A study undertaken to determine the differential effects, if any, of supply source on continuation rates of oral contraceptive usage in Mexican women. A sample of 2063 women aged 15 to 49 years was surveyed over a 6 year period ending in 1979. Of this group, 44% initially obtained the pill from the national family planning population program, 39% from pharmacies, and 17% from private physicians. Average age of users of the 3 sources differed by no more than 1/2 year; government program users tend to be less educated and private physician users to be somewhat more educated than the other women. Results show no striking differences in continuation rates among the 3 groups, and do not support the hypothesis that women who use the pill under supervision of a physician will have a higher continuation rate and lower pregnancy rates than those obtaining their oral contraceptives from other sources. In fact, a group of little educated, older, high parity rural women from among the pharmacy users show slightly higher continuation rates and probabilities of contraceptive use than any other user. In addition, there was no group of women whose contraceptive experience with the pharmacy was less favorable than the experience of women seen by a physician or the family planning program. An interaction effect between the service provider and the contraceptive user which facilitates more effective communication may be in operation across all 3 conditions. Many important questions about access to oral contraceptives, such as incidence of contraindications in users, and incidence and nature of side effects among pill users of various sources, remain unanswered. Further research is needed to clarify these issues. PMID:6965185

  17. [Social and psychological aspects of contraception in adolescents].

    PubMed

    Fortier, L

    1976-09-01

    Reasons for the high adolescent birthrate in the U.S., medical, psychological, and social repercussions of teenage pregnancy, and facts and myths about sex education and contraception for young people are discussed. About 30% of U.S. women under 20 become pregnant outside marriage, and many more are pregnant when they marry. The reasons for the high pregnancy rates in young people include recent early menarch, which accounts for 94% fertility in 17.5-year-olds, better health, and ignorance about contraception and basic facts about reproduction. Pregnant adolescents risk toxemia, anemia, puerperal morbidity, prematurity, neonatal mortality, and congenital defects such as mental retardation in the baby. They face family alienation, loss of educational and employment opportunities, forced marriage, and high suicide rates in addition to the trials of puberty. Many girls believe that their fertile period is during menses, that pills are dangerous, that they are not fertile. Studies have shown that sex education can lower repeat pregnancies 67%. Recent research has negated the belief that many young women desire pregnancy unconsciously. Current information shows that supplying contraception will not encourage young people to begin having intercourse. Most sex education courses in the U.S. are given after the average teenagers become active sexually. It is believed that contraception should be provided universally for young people, and that parental authorization of contraception would probably mend family ties, certainly better than would unwanted pregnancy. PMID:987631

  18. Sexual Initiation, Contraceptive Use, and Pregnancy Among Young Adolescents

    PubMed Central

    Philbin, Jesse M.

    2013-01-01

    OBJECTIVE: To present new data on sexual initiation, contraceptive use, and pregnancy among US adolescents aged 10 to 19, and to compare the youngest adolescents behaviors with those of older adolescents. METHODS: Using nationally representative data from several rounds of the National Survey of Family Growth, we performed event history (ie, survival) analyses to examine timing of sexual initiation and contraceptive use. We calculated adolescent pregnancy rates by single year of age using data from the National Center for Health Statistics, the Guttmacher Institute, and the US Census Bureau. RESULTS: Sexual activity is and has long been rare among those 12 and younger; most is nonconsensual. By contrast, most older teens (aged 1719) are sexually active. Approximately 30% of those aged 15 to 16 have had sex. Pregnancy rates among the youngest teens are exceedingly low, for example, ?1 per 10?000 girls aged 12. Contraceptive uptake among girls as young as 15 is similar to that of their older counterparts, whereas girls who start having sex at 14 or younger are less likely to have used a method at first sex and take longer to begin using contraception. CONCLUSIONS: Sexual activity and pregnancy are rare among the youngest adolescents, whose behavior represents a different public health concern than the broader issue of pregnancies to older teens. Health professionals can improve outcomes for teenagers by recognizing the higher likelihood of nonconsensual sex among younger teens and by teaching and making contraceptive methods available to teen patients before they become sexually active. PMID:23545373

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

    ERIC Educational Resources Information Center

    Gotlib, Ian H.; And Others

    1989-01-01

    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.…

  20. Bombay blood group: Is prevalence decreasing with urbanization and the decreasing rate of consanguineous marriage

    PubMed Central

    Mallick, Sujata; Kotasthane, Dhananjay S.; Chowdhury, Puskar S.; Sarkar, Sonali

    2015-01-01

    Context: Bombay blood group although rare is found to be more prevalent in the Western and Southern states of India, believed to be associated with consanguineous marriage. Aims: To estimate the prevalence of the Bombay blood group (Oh) in the urban population of Puducherry. To find the effect of urbanization on consanguineous marriage and to establish whether consanguinity plays a part in the prevalence of Oh group. To compare Oh group prevalence with that of other neighboring states, where population is not predominantly urban. Settings and Design: This is a descriptive study in a tertiary care hospital in Puducherry, over a period of 6 years. Materials and Methods: All blood samples showing O group were tested with anti-H lectin. Specialized tests like Adsorption Elution Technique, inhibition assay for determination of secretor status were performed on Oh positive cases. Any history of consanguineous marriage was recorded. Statistical Analysis Used: All variables were categorical variable and percentage and proportions were calculated manually. Results: Analysis of the results of 35,497 study subjects showed that the most common group was O group constituting 14,164 (39.90%) of subjects. Only three Oh that is, Bombay phenotype (0.008%) were detected. Consanguinity was observed in two cases (66.66%). Conclusions: This study shows the prevalence of Bombay blood group representing the urban population of Puducherry, to be high (0.008%) and associated with consanguineous marriage (66.66%). Thus, consanguinity is still an important risk factor present, even in an urban population in Southern India. PMID:26420929

  1. Prevalence and incidence density rates of chronic comorbidity in type 2 diabetes patients: an exploratory cohort study

    PubMed Central

    2012-01-01

    Background Evidence-based diabetes guidelines generally neglect comorbidity, which may interfere with diabetes management. The prevalence of comorbidity described in patients with type 2 diabetes (T2D) shows a wide range depending on the population selected and the comorbid diseases studied. This exploratory study aimed to establish comorbidity rates in an unselected primary-care population of patients with T2D. Methods This was a cohort study of 714 adult patients with newly diagnosed T2D within the study period (1985-2007) in a practice-based research network in the Netherlands. The main outcome measures were prevalence and incidence density rates of chronic comorbid diseases and disease clusters. All chronic disease episodes registered in the practice-based research network were considered as comorbidities. We categorised comorbidity into 'concordant' (that is, shared aetiology, risk factors, and management plans with diabetes) and 'discordant' comorbidity. Prevalence and incidence density were assessed for both categories of comorbidity. Results The mean observation period was 17.3 years. At the time of diabetes diagnosis, 84.6% of the patients had one or more chronic comorbid disease of 'any type', 70.6% had one or more discordant comorbid disease, and 48.6% and 27.2% had three or more chronic comorbid diseases of 'any type' or of 'discordant only', respectively. A quarter of those without any comorbid disease at the time of their diabetes diagnosis developed at least one comorbid disease in the first year afterwards. Cardiovascular diseases (considered concordant comorbidity) were the most common, but there were also high rates of musculoskeletal and mental disease. Discordant comorbid diseases outnumbered concordant diseases. Conclusions We found high prevalence and incidence density rates for both concordant and discordant comorbidity. The latter may interfere with diabetes management, thus future research and clinical practice should take discordant comorbidity in patients with T2D into account. PMID:23106808

  2. Myths and Fallacies about Male Contraceptive Methods: A Qualitative Study amongst Married Youth in Slums of Karachi, Pakistan

    PubMed Central

    Nishtar, Noureen; Sami, Neelofar; Faruqi, Anum; Khowaja, Shaneela; Farid-Ul-Hasnain

    2013-01-01

    Pakistan presently has one of the largest cohorts of young people in its history, with around 36 million people between the ages of 15 and 24 years. One of the main reasons for high population growth in Pakistan is almost stagnant contraceptive prevalence rate of 30% nationally and 17.4% amongst youth. The study was conducted to explore the perceptions regarding myths and fallacies related to male contraceptive methods among married youth aged 18-24 year in Karachi, Pakistan. Qualitative exploratory study design was adopted and a total of eight Focus Group Discussions (FGDs) were conducted. Study was conducted in two Union Councils of Korangi Town in the squatter settlement of Karachi, Pakistan from July to September 2010. Thematic analysis was done manually. General, physical, sexual, psychological, socio-cultural and religious were the common categories which lead to myths and fallacies related to condoms use and vasectomy among the married youth. The foremost myth amongst male and female youth was that use of both condoms and vasectomy cause impotence in males. Additionally, condoms were thought to cause infections, backache and headache in males. Some youth of the area think that vasectomy is meant for prisoners only. In conclusion our findings suggest that the potential reasons behind low use of male contraceptive methods among youth of squatter settlement of Karachi were myths and fallacies about male contraceptive methods. There are some important policy implications like counseling of the couple through peers and well trained family planning service providers to address these myths and misconceptions from the minds of youth. PMID:23445697

  3. Belief in Family Planning Myths at the Individual And Community Levels and Modern Contraceptive Use in Urban Africa

    PubMed Central

    Gueye, Abdou; Speizer, Ilene S.; Corroon, Meghan; Okigbo, Chinelo C.

    2016-01-01

    Context Negative myths and misconceptions about family planning are a barrier to modern contraceptive use. Most research on the subject has focused on individual beliefs about contraception; however, given that myths spread easily within communities, it is also important to examine how the prevalence of negative myths in a community affects the aggregate level of method use. Methods Baseline data collected in 2010–2011 by the Measurement, Learning & Evaluation project on women aged 15–49 living in selected cities in Kenya, Nigeria and Senegal were used. Multivariate analyses examined associations between modern contraceptive use and belief in negative myths for individuals and communities. Results In each country, the family planning myths most prevalent at the individual and community levels were that “people who use contraceptives end up with health problems,” “contraceptives are dangerous to women's health” and “contraceptives can harm your womb.” On average, women in Nigeria and Kenya believed 2.7 and 4.6 out of eight selected myths, respectively, and women in Senegal believed 2.6 out of seven. Women's individual-level belief in myths was negatively associated with their modern contraceptive use in all three countries (odds ratios, 0.2–0.7). In Nigeria, the women's community-level myth variable was positively associated with modern contraceptive use (1.6), whereas the men's community-level myth variable was negatively associated with use (0.6); neither community-level variable was associated with modern contraceptive use in Kenya or Senegal. Conclusion Education programs are needed to dispel common myths and misconceptions about modern contraceptives. In Nigeria, programs that encourage community-level discussions may be effective at reducing myths and increasing modern contraceptive use. PMID:26871727

  4. A meta-analysis of prevalence rates and moderating factors for cancer-related post-traumatic stress disorder

    PubMed Central

    Abbey, Gareth; Thompson, Simon B N; Hickish, Tamas; Heathcote, David

    2015-01-01

    Objective Systematic reviews highlight a broad range of cancer-related post-traumatic stress disorder (CR-PTSD) prevalence estimates in cancer survivors. This meta-analysis was conducted to provide a prevalence estimate of significant CR-PTSD symptoms and full diagnoses to facilitate the psychological aftercare of cancer survivors. Methods A systematic literature search was conducted for studies using samples of cancer survivors by using validated clinical interviews and questionnaires to assess the prevalence of CR-PTSD (k = 25, n = 4189). Prevalence estimates were calculated for each assessment method using random-effects meta-analysis. Mixed-effects meta-regression and categorical analyses were used to investigate study-level moderator effects. Results Studies using the PTSD Checklist—Civilian Version yielded lower event rates using cut-off [7.3%, 95% confidence intervals (CI) = 4.5–11.7, k = 10] than symptom cluster (11.2%, 95% CI = 8.7–14.4, k = 9). Studies using the Structured Clinical Interview for Diagnostic and Statistical Manual, Fourth Edition (SCID), yielded low rates for lifetime (15.3%, 95% CI = 9.1–25, k = 5) and current CR-PTSD (5.1%, 95% CI = 2.8–8.9, k = 9). Between-study heterogeneity was substantial (I2 = 54–87%). Studies with advanced-stage samples yielded significantly higher rates with PTSD Checklist—Civilian Version cluster scoring (p = 0.05), and when assessing current CR-PTSD on the SCID (p = 0.05). The effect of mean age on current PTSD prevalence met significance on the SCID (p = 0.05). SCID lifetime prevalence rates decreased with time post-treatment (R2 = 0.56, p < 0.05). Discussion The cancer experience is sufficiently traumatic to induce PTSD in a minority of cancer survivors. Post-hoc analyses suggest that those who are younger, are diagnosed with more advanced disease and recently completed treatment may be at greater risk of PTSD. More research is needed to investigate vulnerability factors for PTSD in cancer survivors. © 2014 The Authors. Psycho-Oncology published by John Wiley & Sons Ltd. PMID:25146298

  5. Effects of Contraceptive Education on Adolescent Male Contraceptive Behavior and Attitudes.

    ERIC Educational Resources Information Center

    Taylor, Mary E.; And Others

    1989-01-01

    The relationship between contraceptive education and teenage male contraceptive behavior was investigated. Findings indicated that brief or moderately in-depth contraceptive education had little effect on contraceptive behavior. The teenage pregnancy and other sex-related problems may make parents and schools more amenable to comprehensive

  6. Contraception and Birth Control: Other FAQs

    MedlinePlus

    ... methods with your sexual partner. What are the health risks and side effects associated with contraception? Different forms of contraception carry different health risks and side effects, and some of them are ...

  7. A comparative trial of the Today contraceptive sponge and diaphragm.

    PubMed

    Edelman, D A; McIntyre, S L; Harper, J

    1984-12-01

    A comparative trial was conducted in the United States to compare the Today contraceptive sponge and the diaphragm used with spermicide. Subjects were randomly assigned to contraceptive methods and were followed up for 1 year. None of the subjects were previous sponge users, but about 30% were previous diaphragm users. The overall cumulative 1-year life-table pregnancy rate was higher for sponge users compared to diaphragm users. No serious side effects occurred with either product. The discontinuation rates for allergic-type reactions and discomfort were higher for sponge users. Similar rates of method-related complaints and discontinuation rates for personal and product-related reasons suggest there were no differences in the acceptability of the two products. In this trial, the allowable use time for the sponge was 2 days. The sponge is now recommended for 1-day use. The overall results of the study indicate the sponge to be a safe and acceptable method of contraception with an effectiveness rate in the range of that for other vaginal contraceptives. PMID:6095664

  8. Pharmacology update in adolescents: contraception and human papillomavirus vaccination.

    PubMed

    Feucht, Cynthia; VandenBussche, Heather

    2013-04-01

    The ideal contraceptive agent remains elusive for the adolescent population. Contraceptive failure is often caused by inappropriate or inconsistent use, and discontinuation within the first year is not uncommon. Various methods have been explored within the adolescent population to increase efficacy rates, minimize side effects, and prevent unwanted pregnancies. The use of intrauterine devices and continuous use of combined oral contraceptives may lead to greater efficacy because of the ease of use and reduction in menstrual symptoms. Recent literature supports the continued use of medroxyprogesterone for adolescents without time limits, and advances in emergency contraception have increased access and use, but have not affected pregnancy rates. Human papillomavirus infection is the most common sexually transmitted infection and is associated with genital warts and the risk for cervical, penile, anal, and vulvovaginal cancer caused by persistent infection. A quadrivalent vaccine is indicated for both males and females to prevent genital warts and cancer, whereas the bivalent vaccine is indicated only for females and cancer prevention. Vaccination rates remain low among adolescents, and except in Virginia and the District of Columbia, vaccination is not a requirement for school entry. Research is ongoing for a 2-dose vaccine to improve vaccination rates while maintaining efficacy. Education is critical to prevent future infections and enhance vaccination rates. PMID:23705519

  9. Contraception and mental health: a commentary on the evidence and principles for practice.

    PubMed

    Hall, Kelli Stidham; Steinberg, Julia R; Cwiak, Carrie A; Allen, Rebecca H; Marcus, Sheila M

    2015-06-01

    Among the most prevalent and disabling chronic diseases affecting reproductive-aged women worldwide, depression and anxiety can contribute to adverse reproductive health outcomes, including an increased risk of unintended pregnancy and its health and social consequences. For women with these common mental health conditions who want to avoid an unintended pregnancy, effective contraception can be an important strategy to maintain and even improve health and well-being. Reproductive health clinicians play a critical role in providing and managing contraception to help women with mental health considerations achieve their desired fertility. In this commentary, we review the literature on relationships between mental health and contraception and describe considerations for the clinical management of contraception among women with depression and anxiety. We discuss issues related to contraceptive method effectiveness and adherence concerns, mental health-specific contraceptive method safety and drug interaction considerations, and clinical counseling and management strategies. Given important gaps in current scientific knowledge of mental health and contraception, we highlight areas for future research. PMID:25511241

  10. Knowledge and use of emergency contraception among students of public secondary schools in Ilorin, Nigeria

    PubMed Central

    Babatunde, Oluwole Adeyemi; Ibirongbe, Demilade Olusola; Omede, Owen; Babatunde, Olubukola Oluwakemi; Durowade, Kabir Adekunle; Salaudeen, Adekunle Ganiyu; Akande, Tanimola Makanjuola

    2016-01-01

    Introduction Unintended pregnancy and unsafe abortion pose a major reproductive health challenge to adolescents. Emergency contraception is safe and effective in preventing unplanned pregnancy. The objective of this study was to assess the student's knowledge and use of emergency contraception. Methods This cross-sectional study was carried out in Ilorin, Nigeria, using multi-stage sampling method. Data was collected using pre-tested semi-structured self-administered questionnaire. Knowledge was scored and analysed. SPSS version 21.0 was used for data analysis. A p-value <0.05 was considered statistically significant. Results 27.8% of the respondents had good knowledge of emergency contraception. Majority of respondents (87.2%) had never used emergency contraception. Majority of those who had ever used emergency contraception (85.7%) used it incorrectly, using it more than 72 hours after sexual intercourse (p=0.928). Conclusion Knowledge about Emergency contraception and prevalence of use were low. Contraceptive education should be introduced early in the school curriculum for adolescents. PMID:27217897

  11. Helping Clinicians Prevent Pregnancy among Sexually Active Adolescents: U.S. Medical Eligibility Criteria for Contraceptive Use and U.S. Selected Practice Recommendations for Contraceptive Use.

    PubMed

    Godfrey, Emily M

    2015-08-01

    The United States has made substantial progress in reducing teenage birth rates in recent decades, but rates remain high. Teen pregnancy can increase the risk of poor health outcomes and lead to decreased educational attainment, increased poverty, and welfare use, as well as increased cost to taxpayers. One of the most effective ways to prevent teenage pregnancy is through the use of effective birth control methods. The Centers for Disease Control (CDC) and Prevention has made the prevention of teenage pregnancy 1 of its 10 winnable battles. The CDC has released 2 evidence-based clinical guideline documents regarding contraceptive use for adolescents and adults. The first guideline, US Medical Eligibility Criteria for Contraceptive Use, 2010, helps clinicians recognize when a contraceptive method may not be safe to use for a particular adolescent but also when not to withhold a contraceptive method that is safe to use. The second document, US Selected Practice Recommendations for Contraceptive Use, 2013, provides guidance for how to use contraceptive methods safely and effectively once they are deemed safe. Health care providers are encouraged to use these documents to provide safe and effective contraceptive care to patients seeking family planning, including adolescents. PMID:26026219

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

    PubMed Central

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

    2007-01-01

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

  13. The latest advances in hormonal contraception.

    PubMed

    Fontenot, Holly B; Harris, Allyssa L

    2008-01-01

    Millions of women each year start or continue to use some type of hormonal contraceptive method. Choosing a method may be anxiety provoking. In this article, we review some of the latest advances in and options for hormonal contraception, including extended-dose oral contraceptives, the vaginal ring, injectable methods, and emergency contraception. Nurses can facilitate women's decision making for healthy reproductive options. PMID:18507610

  14. Emergency contraception review: evidence-based recommendations for clinicians

    PubMed Central

    Cleland, Kelly; Raymond, Elizabeth G.; Westley, Elizabeth; Trussell, James

    2014-01-01

    Several options for emergency contraception are available in the United States. This article describes each method, including efficacy, mode of action, safety, side effect profile and availability. The most effective emergency contraceptive is the copper IUD, followed by ulipristal acetate and levonorgestrel pills. Levonorgestrel is available for sale without restrictions, while ulipristal acetate is available with prescription only, and the copper IUD must be inserted by a clinician. Although EC pills have not been shown to reduce pregnancy or abortion rates at the population level, they are an important option for individual women seeking to prevent pregnancy after sex. PMID:25254919

  15. Emergency contraception review: evidence-based recommendations for clinicians.

    PubMed

    Cleland, Kelly; Raymond, Elizabeth G; Westley, Elizabeth; Trussell, James

    2014-12-01

    Several options for emergency contraception are available in the United States. This article describes each method, including efficacy, mode of action, safety, side effect profile, and availability. The most effective emergency contraceptive is the copper intrauterine device (IUD), followed by ulipristal acetate and levonorgestrel pills. Levonorgestrel is available for sale without restrictions, whereas ulipristal acetate is available with prescription only, and the copper IUD must be inserted by a clinician. Although EC pills have not been shown to reduce pregnancy or abortion rates at the population level, they are an important option for individual women seeking to prevent pregnancy after sex. PMID:25254919

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

    PubMed Central

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

    2011-01-01

    Uterine leiomyomata are common, affecting 7080% 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 30.48.0 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

  17. Survival analysis of time to uptake of modern contraceptives among sexually active women of reproductive age in Nigeria

    PubMed Central

    Adebowale, Ayo Stephen; Morhason-Bello, ImranOludare

    2015-01-01

    Objective To assess the timing of modern contraceptive uptake among married and never-married women in Nigeria. Design A retrospective cross-sectional study. Data and method We used nationally representative 2013 Demographic and Health Survey data in Nigeria. Modern contraceptive uptake time was measured as the period between first sexual intercourse and first use of a modern contraceptive. Non-users of modern contraceptives were censored on the date of the survey. Kaplan–Meier survival curves were used to determine the rate of uptake. A Cox proportional-hazards model was used to determine variables influencing the uptake at 5% significance level. Participants A total of 33 223 sexually active women of reproductive age. Outcome measure Time of uptake of a modern contraceptive after first sexual intercourse. Results The median modern contraceptive uptake time was 4 years in never-married and 14 years among ever-married women. Significant differences in modern contraceptive uptake existed in respondents’ age, location, education and wealth status. Never-married women were about three times more likely to use a modern contraceptive than ever-married women (aHR=3.24 (95% CI 2.82 to 3.65)). Women with higher education were six times more likely to use a modern contraceptive than those without education (aHR=6.18 (95% CI 5.15 to 7.42)). Conclusions The rate of modern contraceptive uptake is low, and timing of contraceptive uptake during or after first sexual intercourse differed according to marital status. Age and number of children ever born influenced modern contraceptive uptake among the never-married women, but religion and place of residence were associated with the probability of modern contraceptive uptake among ever-married women. PMID:26671948

  18. Contraception options shrinking -- US expert.

    PubMed

    Mulley, S

    1996-03-15

    While some investigators are optimistic about such new contraceptive agents as injectable male hormonal contraceptives (clinical trials involve weekly injections of 50 mg or 100 mg testosterone), other researchers feel that the research portfolio is shrinking. New barrier methods undergoing tests include the Femcap (cervical cap); Lea's Shield, which has a one-way valve to allow the outward flow of mucus and menses but block the inward flow of sperm; and a new kind of sponge. Contraceptive vaginal rings may be available within five years, and research into vaccine development continues. A frameless IUD, consisting of a nonbiodegradable thread and copper rings, is undergoing trials sponsored by the World Health Organization. PMID:12179196

  19. Emergency Contraception: An Updated Review

    PubMed Central

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

    2011-01-01

    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

  20. High Rates of Pregnancy among Vocational School Students: Results of Audio Computer-Assisted Self-Interview Survey in Chiang Rai, Thailand.

    ERIC Educational Resources Information Center

    Manopaiboon, Chomnad; Kilmarx, Peter H.; van Griensven, Frits; Chaikummao, Supaporn; Jeeyapant, Supaporn; Limpakarnjanarat, Khanchi; Uthaiworavit, Wat

    2003-01-01

    Examined prevalence of and factors associated with pregnancy and abortion among vocation school students in northern Thailand. Age, current contraceptive use, early initiation of sexual intercourse, alcohol and drug use, and sexual coercion were associated with self or partner pregnancy. High rates of pregnancy and abortion indicate the need for…

  1. High Rates of Pregnancy among Vocational School Students: Results of Audio Computer-Assisted Self-Interview Survey in Chiang Rai, Thailand.

    ERIC Educational Resources Information Center

    Manopaiboon, Chomnad; Kilmarx, Peter H.; van Griensven, Frits; Chaikummao, Supaporn; Jeeyapant, Supaporn; Limpakarnjanarat, Khanchi; Uthaiworavit, Wat

    2003-01-01

    Examined prevalence of and factors associated with pregnancy and abortion among vocation school students in northern Thailand. Age, current contraceptive use, early initiation of sexual intercourse, alcohol and drug use, and sexual coercion were associated with self or partner pregnancy. High rates of pregnancy and abortion indicate the need for

  2. Teen Council urges improved contraceptive accessibility.

    TOXLINE Toxicology Bibliographic Information

    1988-07-01

    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.

  3. Equity and women's health services for contraception, abortion and childbirth in Brazil.

    PubMed

    Diniz, Simone G; d'Oliveira, Ana Flávia Pires Lucas; Lansky, Sonia

    2012-12-01

    This paper addresses equity in health and health care in Brazil, examining unjust disparities between women and men, and between women from different social strata, with a focus on services for contraception, abortion and pregnancy. In 2010 women's life expectancy was 77.6 years, men's was 69.7 years. Women are two-thirds of public hospital services users and assess their health status less positively than men. The total fertility rate was 1.8 in 2011, and contraceptive prevalence has been high among women at all income levels. The proportion of sterilizations has decreased; lower-income women are more frequently sterilized. Abortions are mostly illegal; women with more money have better access to safe abortions in private clinics. Poorer women generally self-induce abortion with misoprostol, seeking treatment of complications from public clinics. Institutional violence on the part of health professionals is reported by half of women receiving abortion care and a quarter of women during childbirth. Maternity care is virtually universal. The public sector has fewer caesarean sections, fewer low birthweight babies, and more rooming-in, but excessive episiotomies and inductions. Privacy, continuity of care and companionship during birth are more common in the private sector. To achieve equity, the health system must go beyond universal, unregulated access to technology, and move towards safe, effective and transparent care. PMID:23245414

  4. Prevalence and rates of intimate partner violence among South African women during pregnancy and the postpartum period

    PubMed Central

    Groves, Allison K.; Moodley, Dhayendre; McNaughton-Reyes, Luz; Martin, Sandra L.; Foshee, Vangie; Maman, Suzanne

    2014-01-01

    Objectives Intimate partner violence (IPV) is a significant public health problem in South Africa. However, limited research exists on IPV during pregnancy and the postpartum period in South Africa. The purpose of this study is to describe the prevalence, rates and correlates of IPV among South African women during pregnancy and the first nine months postpartum. Methods Data are from a longitudinal study with women recruited during pregnancy between 2008 and 2010 at a public clinic in Durban. We used a modified version of the World Health Organization’s IPV scale to estimate prevalence and rates of IPV during pregnancy, at four months postpartum and nine months postpartum and we used logistic regression to assess the correlates of IPV during this time. Results More than 20% of all women experienced at least one act of physical, psychological or sexual IPV during pregnancy. Nearly one-quarter of all women experienced at least one act of physical, psychological or sexual IPV during the first nine months postpartum. Psychological IPV was the most prevalent type of IPV during pregnancy and the first four months postpartum. Age and previous violence within the relationship were associated with IPV during pregnancy and IPV during the postpartum period. Conclusions The high levels of IPV during pregnancy and the postpartum period highlight the need to develop screening and intervention strategies specifically for this time. Further, women should be screened not only for physical violence but also psychological violence given that psychological violence may result in distinct negative consequences. PMID:24889116

  5. High prevalence, low awareness, treatment and control rates of hypertension in Guinea: results from a population-based STEPS survey.

    PubMed

    Camara, A; Baldé, N M; Diakité, M; Sylla, D; Baldé, E H; Kengne, A P; Baldé, M D

    2016-04-01

    Hypertension is a major and fast-growing public health problem in Africa. We determined the prevalence of hypertension and assessed the levels of awareness, treatment and control in Guinea. A cross-sectional study based on a stratified cluster random sampling was conducted. In all, 2491 adults (1351 women) aged 15-64 years were selected and screened during September-December 2009. Hypertension (systolic (and/or diastolic) blood pressure ⩾140 (90) mm Hg or use of antihypertensive medications) and diabetes mellitus (fasting capillary glucose ⩾110  mg dl(-1) or use of antidiabetic medications) were determined. Logistic regressions were used to investigate the determinants of hypertension. The mean body mass index was 22.4  kg m(-2) (s.d.=4.5). The prevalence of hypertension and diabetes was, respectively, 29.9% (95% confidence interval (CI) 29.8-30.0) and 3.5% (95%CI 3.4-3.5). The prevalence of hypertension was 29.4% (29.3-29.5) in men and 30.4% (30.4-30.6) in women. The prevalence was 62.5% in the 44-64 years age group. Overall, 75.8% of hypertensive participants were undetected before the survey and 34.9% of those aware of their hypertensive status were receiving treatment, of whom 16.3% were at target control levels. Age, education, diabetes and obesity were the main factors associated with hypertension. There was a high prevalence of hypertension among the adults in Guinea, but with low awareness, treatment and control rates. Urgent response is needed in the form of integrated and comprehensive action targeting major non-communicable diseases in the country. PMID:26310186

  6. Emergency contraception. Widely available and effective but disappointing as a public health intervention: a review

    PubMed Central

    Baird, D.T.; Cameron, S.; Evers, J.L.H.; Gemzell-Danielsson, K.; Glasier, A.; Moreau, C.; Trussell, J.; von Hertzen, H.; Crosignani, P.G.; La Vecchia, C.; Volpe, A.; Glasier, A.; Crosignani, P.G.

    2015-01-01

    Emergency contraception (EC) prevents pregnancy after unprotected sex or contraceptive failure. Use of EC has increased markedly in countries where a product is available over the counter, yet barriers to availability and use remain. Although effective in clinical trials, it has not yet been possible to show a public health benefit of EC in terms of reduction of unintended pregnancy rates. Selective progesterone receptor modulators developed as emergency contraceptives offer better effectiveness than levonorgestrel, but still EC is less effective than use of ongoing regular contraception. Methods which inhibit ovulation whenever they are taken or which act after ovulation to prevent implantation and strategies to increase the uptake of effective ongoing contraception after EC use would prevent more pregnancies. PMID:25678571

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

    PubMed

    Schuklenk, Udo; Kleinsmidt, Anita

    2007-07-01

    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

  8. Transmission rates, screening methods and costs of MRSA--a systematic literature review related to the prevalence in Germany.

    PubMed

    Tübbicke, A; Hübner, C; Kramer, A; Hübner, N-O; Fleßa, S

    2012-10-01

    Methicillin-resistant Staphylococcus aureus (MRSA) infections represent a serious challenge for health care institutions, which is inherent in the combination of prevalence, transmission rates and costs. Furthermore, performing an MRSA screening requires information on the complex system of effectiveness, accuracy and costs of different screening methods. The purpose of this study was to give an overview of parameters with decisive significance for the burden of MRSA and the selection of a specific MRSA screening strategy. A systematic literature search for peer-reviewed health economic studies associated with MRSA was performed (from 1995 to the present). Eighty-seven different studies met all inclusion and exclusion criteria. Primary outcomes included the prevalence of MRSA, MRSA transmission rates, performance characteristics of MRSA screening methods, costs for pre-emptive isolation precautions and costs per MRSA case. The prevalence rates reported for all inpatients (1.2-5.3 %) as well as for inpatients with risk factors or patients in risk areas (3.85-20.6 %) vary greatly. The range of cross-transmission rates per day reported for patients with MRSA in isolation is 0.00081-0.009 and for carriers not in isolation is 0.00137-0.140, respectively. For polymerase chain reaction (PCR) methods, the mean sensitivity and specificity were 91.09 and 95.79 %, respectively. Culture methods show an average sensitivity of 89.01 % and an average specificity of 93.21 %. The turn-around time for PCR methods averages 15 h, while for the culture method, it can only be estimated as 48-72 h. This review filtered important parameters and cost drivers, and covered them with literature-based averages. These findings serve as an ideal evidence base for further health economic considerations of the cost-effectiveness of different MRSA screening methods. PMID:22573360

  9. Contraception and Unintended Pregnancy among Unmarried Female University Students: A Cross-sectional Study from China.

    PubMed

    Wang, Hongjing; Long, Lu; Cai, Hui; Wu, Yue; Xu, Jing; Shu, Chang; Wang, Peng; Li, Bo; Wei, Qinyu; Shang, Xuejun; Wang, Xueyi; Zhang, Meimei; Xiong, Chengliang; Yin, Ping

    2015-01-01

    This study aims to understand the level of contraceptive knowledge and attitudes towards contraception, and then to explore the association between the contraceptive behavior and unintended pregnancy in unmarried female university students in China. A cross-sectional study was conducted of university students in 49 universities across 7 cities in China from September 2007 to January 2008. We distributed 74,800 questionnaires, of which 69,842 were returned. In this paper, the data from 35,383 unmarried female university students were analyzed. The prevalence of sexual intercourse in unmarried female university students was 10.2%. The prevalence of unintended pregnancy in those sexually active female university students, was 31.8%. Among students with pregnancy, 53.5% experienced two or more pregnancies. 28.3% of the students with sexual intercourse reported that they always adopted contraceptive methods, and of those 82.9% chose to use male condoms. The majority (83.9%) of students with unintended pregnancy chose to terminate the latest pregnancy by surgical abortion or medical abortion. The contraceptive knowledge level of students who experienced unintended pregnancy was lower than those who did not. In China, about one third of unmarried female students with sexual intercourse experience unintended pregnancy. A variety of contraceptive methods are adopted, but the frequency of contraceptive use is low. Most of unmarried female students who experienced unintended pregnancy would choose to terminate the pregnancy with surgical or medical abortion. University students, especially the ones who have experienced unintended pregnancy, lack contraceptive and reproductive health knowledge. PMID:26091505

  10. Contraception and Unintended Pregnancy among Unmarried Female University Students: A Cross-sectional Study from China

    PubMed Central

    Wang, Hongjing; Long, Lu; Cai, Hui; Wu, Yue; Xu, Jing; Shu, Chang; Wang, Peng; Li, Bo; Wei, Qinyu; Shang, Xuejun; Wang, Xueyi; Zhang, Meimei; Xiong, Chengliang; Yin, Ping

    2015-01-01

    This study aims to understand the level of contraceptive knowledge and attitudes towards contraception, and then to explore the association between the contraceptive behavior and unintended pregnancy in unmarried female university students in China. A cross-sectional study was conducted of university students in 49 universities across 7 cities in China from September 2007 to January 2008. We distributed 74,800 questionnaires, of which 69,842 were returned. In this paper, the data from 35,383 unmarried female university students were analyzed. The prevalence of sexual intercourse in unmarried female university students was 10.2%. The prevalence of unintended pregnancy in those sexually active female university students, was 31.8%. Among students with pregnancy, 53.5% experienced two or more pregnancies. 28.3% of the students with sexual intercourse reported that they always adopted contraceptive methods, and of those 82.9% chose to use male condoms. The majority (83.9%) of students with unintended pregnancy chose to terminate the latest pregnancy by surgical abortion or medical abortion. The contraceptive knowledge level of students who experienced unintended pregnancy was lower than those who did not. In China, about one third of unmarried female students with sexual intercourse experience unintended pregnancy. A variety of contraceptive methods are adopted, but the frequency of contraceptive use is low. Most of unmarried female students who experienced unintended pregnancy would choose to terminate the pregnancy with surgical or medical abortion. University students, especially the ones who have experienced unintended pregnancy, lack contraceptive and reproductive health knowledge. PMID:26091505

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

    PubMed Central

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

    2012-01-01

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

  12. Comparison of prevalence and resection rates in patients with esophageal squamous cell carcinoma and adenocarcinoma.

    PubMed

    Heitmiller, R F; Sharma, R R

    1996-07-01

    Since 1987 we have observed a predominance of adenocarcinoma in patients undergoing esophagectomy because of carcinoma at our institution. To discover whether this observation represented an actual change in the prevalence of adenocarcinoma, the Johns Hopkins Hospital pathology records were reviewed for the years 1959 to 1994. Overall, esophageal squamous cell carcinoma was the most common histologic type with 817 cases identified versus 284 cases of adenocarcinoma. The number of patients with squamous cell carcinoma rose slowly from 1959 to 1992 but since 1992 has decreased. Whereas adenocarcinoma was uncommon before 1978, its frequency has since increased markedly, exceeding that of squamous cell carcinoma in 1994. The number of patients with adenocarcinoma who underwent surgical resection has equaled or exceeded the number of those treated nonoperatively for all recorded years. Therefore the predominance of adenocarcinoma in patients undergoing esophageal resection for carcinoma appears to result from two factors: an overall increase in the prevalence of adenocarcinoma since 1978 and an increased likelihood of resection for patients with these tumors. PMID:8691857

  13. Recent developments in barrier methods of contraception.

    PubMed

    Richardson, H

    1988-11-01

    Women have used contraceptive barriers for centuries, such as leaves, to prevent pregnancy and sexually transmitted diseases (STDs). Spermicides are used with at least 3 of the 5 modern female barrier methods -- the diaphragm, the cap, and the sponge. The thin domed rubber diaphragms lie diagonally across the cervix, the vault, and part of the anterior vaginal wall. Suction holds the cervical/vault caps in place. Women must be fitted for these 2 methods before use. Women can buy a small polyurethane sponge impregnated with 1 gram of nonoxynol-9 spermicide to cover the cervix over the counter. It has a high failure rate, however, since adequate instructions for insertion are not provided. The vaginal ring is not designed to fit into 1 fixed position in the vagina, yet probably spends most of its time in the posterior fornix. The ring continuously releases the levonorgestrel or a spermicide. The recently developed vaginal shield or female sheath has promise. It is a hollow tube made of strong elastic polyurethane. Since the era of the ancient Romans and Egyptians, men have used barriers made of such diverse material as animal bladders, silk, and lamb intestine, to protect against dirt and disease or for decoration. Condoms were 1st manufactured in the 1900s and had to be washed and dried following each act of intercourse. With the increase in STDs during World War II, condom distribution to the troops became standard practice. Today condoms come in a variety of colors, lengths, and strengths. Some have been coated with the spermicide nonoxynol-9 which protects against STDs. The condom follows oral contraceptives as the most popular form of contraceptive in the United Kingdom. A 1987 television campaign to promote barrier method use in light of the AIDS epidemic backfired. For example, it implied that diaphragms and sponges protect women from HIV. PMID:3231142

  14. Women's contraceptive attitudes and use in 1992.

    PubMed

    Forrest, J D; Fordyce, R R

    1993-01-01

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

  15. Contraceptive Coverage and the Affordable Care Act.

    PubMed

    Tschann, Mary; Soon, Reni

    2015-12-01

    A major goal of the Patient Protection and Affordable Care Act is reducing healthcare spending by shifting the focus of healthcare toward preventive care. Preventive services, including all FDA-approved contraception, must be provided to patients without cost-sharing under the ACA. No-cost contraception has been shown to increase uptake of highly effective birth control methods and reduce unintended pregnancy and abortion; however, some institutions and corporations argue that providing contraceptive coverage infringes on their religious beliefs. The contraceptive coverage mandate is evolving due to legal challenges, but it has already demonstrated success in reducing costs and improving access to contraception. PMID:26598303

  16. Contraception and adolescents: highlights from the NASPAG conference.

    PubMed

    1995-07-01

    The ninth annual meeting (1995) of the North American Society for Pediatric and Adolescent Gynecology included presentations on trends in adolescent sexual activity and pregnancy, contraceptive usage, and suitability of subdermal implants. In the US, 56% of females and 73% of males have had intercourse by the age of 18 years. Although the US adolescent pregnancy rate has remained stable, the rate of nonmarital adolescent births is increasing. Half of all unintended teen pregnancies occur within six months of becoming sexually active, and only two-thirds of adolescents use contraception at first intercourse. Adolescents' contraceptive choices are influenced by popularity of a method among peers, accessibility, and fear of side effects. About 40% select oral contraceptives and 26% rely on condoms, while another 21% are non-users. Final data from a three-year study of subdermal implant use in an adolescent population suggested a high degree of satisfaction with the method, but concerns about weight gain. Another study achieved a four-year continuation rate of 85% for adolescent implant acceptors (90% for adult acceptors) through a rigorous program of supportive counseling, client education, and surveillance. PMID:12319565

  17. Practice Bulletin Summary No. 152: Emergency Contraception.

    PubMed

    2015-09-01

    Emergency contraception, also known as postcoital contraception, is therapy used to prevent pregnancy after an unprotected or inadequately protected act of sexual intercourse. Common indications for emergency contraception include contraceptive failure (eg, condom breakage or missed doses of oral contraceptives) and failure to use any form of contraception (1-3). Although oral emergency contraception was first described in the medical literature in the 1960s, the U.S. Food and Drug Administration (FDA) approved the first dedicated product for emergency contraception in 1998. Since then, several new products have been introduced. Methods of emergency contraception include oral administration of combined estrogen-progestin, progestin only, or selective progesterone receptor modulators and insertion of a copper intrauterine device (IUD). Many women are unaware of the existence of emergency contraception, misunderstand its use and safety, or do not use it when a need arises (4-6). The purpose of this Practice Bulletin is to review the evidence for the efficacy and safety of available methods of emergency contraception and to increase awareness of these methods among obstetrician-gynecologists and other gynecologic providers. PMID:26287780

  18. Practice Bulletin No. 152: Emergency Contraception.

    PubMed

    2015-09-01

    Emergency contraception, also known as postcoital contraception, is therapy used to prevent pregnancy after an unprotected or inadequately protected act of sexual intercourse. Common indications for emergency contraception include contraceptive failure (eg, condom breakage or missed doses of oral contraceptives) and failure to use any form of contraception (). Although oral emergency contraception was first described in the medical literature in the 1960s, the U.S. Food and Drug Administration (FDA) approved the first dedicated product for emergency contraception in 1998. Since then, several new products have been introduced. Methods of emergency contraception include oral administration of combined estrogen-progestin, progestin only, or selective progesterone receptor modulators and insertion of a copper intrauterine device (IUD). Many women are unaware of the existence of emergency contraception, misunderstand its use and safety, or do not use it when a need arises (). The purpose of this Practice Bulletin is to review the evidence for the efficacy and safety of available methods of emergency contraception and to increase awareness of these methods among obstetrician-gynecologists and other gynecologic providers. PMID:26287787

  19. Contraception in the prepill era.

    PubMed

    Connell, E B

    1999-01-01

    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

  20. Contraception and the Adolescent Diabetic.

    ERIC Educational Resources Information Center

    Fennoy, Ilene

    1989-01-01

    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…

  1. An animal welfare view of wildlife contraception.

    PubMed

    Grandy, J W; Rutberg, A T

    2002-01-01

    Although there is some dissent, the animal protection community generally supports the concept of wildlife contraception. However, some contraceptive agents, delivery mechanisms and specific applications will be opposed by animal welfare advocates on environmental, humane or other ethical grounds, and some animal rights advocates may oppose wildlife contraception entirely. The Humane Society of the United States (HSUS) has supported and conducted wildlife contraception studies for more than 10 years. In general, we have invested in contraceptive agents (such as porcine zona pellucida) that we believe will prove environmentally, physiologically and behaviourally benign, and in delivery mechanisms that are narrowly targeted. As we consider contraception to be a major intervention into natural processes, we believe that wildlife contraception should be applied judiciously, locally and in a manner that is sensitive to the needs of animals, humans and ecosystem function. PMID:12220149

  2. Metabolic effects of contraceptive steroids.

    PubMed

    Sitruk-Ware, Regine; Nath, Anita

    2011-06-01

    Estrogen and progestins have been used by millions of women as effective combined contraceptives. The safety of hormonal contraceptives has been documented by years of follow-up and serious adverse events that may be related to their use are rare in the young population exposed to these agents. The balance between the benefits and the risks of contraceptive steroids is generally positive in particular when comparing to the risks of pregnancy and especially in women with risk factors. The metabolic changes induced by the synthetic steroids used in contraception, such as lipoprotein changes, insulin response to glucose, and coagulation factors have been considered as potential markers of cardiovascular and venous risk. Observations of these effects have led to modifications of the composition of hormonal contraceptive in order to minimize these changes and hence potentially decrease the risks. The synthetic estrogen Ethinyl-Estradiol (EE) exerts a stronger effect that natural estradiol (E2) on hepatic metabolism including estrogen-dependent markers such as liver proteins. This stronger hepatic impact of EE has been related to its 17α-ethinyl group which prevents the inactivation of the molecule and results in a more pronounced hepatic effect of EE as compared to estradiol. Due to its strong activity, administering EE via a non-oral route does not prevent its impact on liver proteins. In order to circumvent the metabolic changes induced by EE, newer products using more natural compounds such as estradiol (E2) and estradiol valerate (E2V) have been introduced. The synthetic progestins used for contraception are structurally related either to testosterone (T) (estranes and gonanes) or to progesterone (pregnanes and 19-norpregnanes). Several new progestins have been designed to bind more specifically to the progesterone receptor and to minimize side-effects related to androgenic, estrogenic or glucocorticoid receptor interactions. Dienogest (DNG), and drospirenone (DRSP) and the 19-norpregnanes including Nestorone® (NES), nomegestrol acetate (NOMAc) and trimegestone (TMG) have been combined with estrogen either EE or E2 or estradiol valerate (E2V). Risks and benefits of the newer progestins used in contraception depend upon the type of molecular structure, the type and dose of estrogen associated in a combination and the route of administration. The lower metabolic impact of estradiol-based combinations may result in an improved safety profile, but large surveillance studies are warranted to confirm this plausible hypothesis. So far, the contraindications and warnings for use of current COCs also apply to the estradiol-based COCs. PMID:21538049

  3. Alcohol use and contraception in first sexual experiences.

    PubMed

    Leigh, B C; Schafer, J; Temple, M T

    1995-02-01

    Recent research has suggested that the use of alcohol or drugs in conjunction with sexual intercourse is associated with nonuse of contraception, particularly in first intercourse experiences. This paper reports findings from a nationally representative sample of adolescents and young adults aged 18-30 who were asked a number of questions about the circumstances and characteristics of the first time they had intercourse. Results showed that drinking at the time of first intercourse was more prevalent among those who first had sex prior to 1985; moreover, members of this cohort were less likely to use condoms or other forms of birth control at the time of first intercourse. Drinking was associated with nonuse of contraception only among those who had their first sexual experience prior to 1985. The results are discussed in terms of historical changes in the sexual climate of the AIDS era. PMID:7595954

  4. Prevalence, injury rate and, symptom frequency in generalized joint laxity and joint hypermobility syndrome in a "healthy" college population.

    PubMed

    Russek, Leslie N; Errico, Deanna M

    2016-04-01

    Generalized joint hypermobility (GJH) and joint hypermobility syndrome (JHS) are gaining increased attention as potential sources of pain and injury. The aims of this study were to evaluate prevalence of GJH and JHS and to determine whether musculoskeletal injuries and symptoms commonly attributed to GJH and JHS were more common within a "healthy" college student population. The study involved a convenience sample of 267 college and graduate students, aged 17-26. GJH was assessed using the Beighton score with a cutoff of 5/9, while JHS was assessed using the Brighton criteria. Injury history and symptoms were assessed by recall. Prevalence of GJH was 26.2 % overall (females 36.7 %, males 13.7 %). Prevalence of JHS was 19.5 % overall (females 24.5 %, males 13.7 %). Injury rates were not significantly different for individuals who had GJH vs. those who did not have GJH. Individuals with JHS were significantly more likely to have had sprains, back pain, and stress fractures. Symptoms were no different between those with GJH and those who did not have GJH. However, individuals with JHS were significantly more likely to report clumsiness, easy bruising, and balance problems than those who did not have JHS. GJH and JHS were relatively common in this healthy college student population; GJH was not associated with increased incidence of injury or symptoms commonly attributed to JHS, but JHS was associated with increased incidence of some injuries and symptoms. PMID:25930211

  5. Prevalence and Determinants of Chronic Kidney Disease Among Hypertensive Cameroonians According to Three Common Estimators of the Glomerular Filtration Rate.

    PubMed

    Kaze, Francois Folefack; Kengne, Andre-Pascal; Magatsing, Carine Tchendjou; Halle, Marie-Patrice; Yiagnigni, Euloge; Ngu, Kathleen Blackett

    2016-05-01

    Hypertension is a risk factor for renal diseases, which, in turn, are precursors of hypertension. The authors assessed the prevalence and determinants of chronic kidney disease (CKD) among 336 hypertensive adult Cameroonians (mean age, 60.9±11.3 years; 63.4% women) at Yaoundé. Any participant with an estimated glomerular filtration rate <60 mL/min/1.73 m(2) regardless of the equation used (Cockcroft-Gault [CG], Modification of Diet in Renal Disease [MDRD], and Chronic Kidney Disease Epidemiology Collaboration [CKD-EPI]) and/or dipstick proteinuria was reviewed 3 months later. Participants presented a high prevalence of diabetes (18.5%), dyslipidemia (17.6%), gout/hyperuricemia (10.7%), overweight/obesity (68.8%), self-medication (37.5%), and alcohol consumption (33.3%). Hypertension was uncontrolled in 265 patients (78.9%). The prevalence of CKD was 49.7%, 50.0%, and 52.1% according to MDRD, CKD-EPI, and CG equations, respectively. Advanced age, adiposity, and severity of hypertension were determinants of CKD. Nearly half of the hypertensive patients had CKD regardless of the estimators used, predicted by well-known risk factors. PMID:26791352

  6. Prevalence rate, predictors and long-term course of probable posttraumatic stress disorder after major trauma: a prospective cohort study

    PubMed Central

    2012-01-01

    Background Among trauma patients relatively high prevalence rates of posttraumatic stress disorder (PTSD) have been found. To identify opportunities for prevention and early treatment, predictors and course of PTSD need to be investigated. Long-term follow-up studies of injury patients may help gain more insight into the course of PTSD and subgroups at risk for PTSD. The aim of our long-term prospective cohort study was to assess the prevalence rate and predictors, including pre-hospital trauma care (assistance of physician staffed Emergency Medical Services (EMS) at the scene of the accident), of probable PTSD in a sample of major trauma patients at one and two years after injury. The second aim was to assess the long-term course of probable PTSD following injury. Methods A prospective cohort study was conducted of 332 major trauma patients with an Injury Severity Score (ISS) of 16 or higher. We used data from the hospital trauma registry and self-assessment surveys that included the Impact of Event Scale (IES) to measure probable PTSD symptoms. An IES-score of 35 or higher was used as indication for the presence of probable PTSD. Results One year after injury measurements of 226 major trauma patients were obtained (response rate 68%). Of these patients 23% had an IES-score of 35 or higher, indicating probable PTSD. At two years after trauma the prevalence rate of probable PTSD was 20%. Female gender and co-morbid disease were strong predictors of probable PTSD one year following injury, whereas minor to moderate head injury and injury of the extremities (AIS less than 3) were strong predictors of this disorder at two year follow-up. Of the patients with probable PTSD at one year follow-up 79% had persistent PTSD symptoms a year later. Conclusions Up to two years after injury probable PTSD is highly prevalent in a population of patients with major trauma. The majority of patients suffered from prolonged effects of PTSD, underlining the importance of prevention, early detection, and treatment of injury-related PTSD. PMID:23270522

  7. Oral contraceptives in adolescent women.

    PubMed

    Bitzer, Johannes

    2013-02-01

    Taking into account the biological and psychosocial changes during the transition from childhood to adulthood adolescents would need a contraceptive method which ideally would be very effective, independent of compliance, without major health risks during use and no negative impact on the future health of the adolescent, protective against STI, favorable for bone development, with no or only few side effects and having some preventive and therapeutic potential with respect to frequent health problems of adolescent girls. Combined oral contraceptives (COC) used regularly and consistently have a more than 99% efficacy to prevent a pregnancy. COCs have a very low health risk (almost exclusively thromboembolic disease) which seems to differ marginally with respect to dosage and type of the components. Progestogen only oral contraceptives do not have any major negative health impact. The leading side effect is irregular bleeding which in COC users is mainly during the first 3 months and in progestogen only users during the period of use. Other side effects are reported but their frequency is similar to placebo. COC protect against endometrial and ovarian cancer and they may have beneficial effects on a variety of menstrual complaints and acne, which are frequent problems during adolescence. To be effective COCs have to be taken regularly which is frequently not the case. This diminishes considerably their effectiveness depending on the individual compliance. They do not protect against STI and may even have an inhibitory effect on the use of condoms. For most adolescents the risk benefit profile of oral contraceptives is favorable and makes this method valuable. At the same time the prescription of oral contraceptives for adolescents need to be individualized by taking into account the individual risk/benefit profile. Specialized counseling with a high degree of confidentiality adapted to the knowledge and needs of the individual adolescent is desirable. PMID:23384748

  8. The effect of oral contraceptive formulation and field-workers: a cautionary tale.

    PubMed

    Miller, P C; Donaldson, P J; Basnayake, S; de Silva, S V

    1985-02-01

    This paper examines oral contraceptive continuation rates and reported side effects in a large scale clinical research project conducted in Sri Lanka. The project evaluated standard- and low-dose pills used with and without vitamin supplements. Differences in continuation rates and perception of side effects are used to illustrate the impact that family planning field-workers can have on women's use of oral contraceptives. PMID:2860026

  9. Estimating Contraceptive Needs and Increasing Access to Contraception in Response to the Zika Virus Disease Outbreak - Puerto Rico, 2016.

    PubMed

    Tepper, Naomi K; Goldberg, Howard I; Bernal, Manuel I Vargas; Rivera, Brenda; Frey, Meghan T; Malave, Claritsa; Renquist, Christina M; Bracero, Nabal Jose; Dominguez, Kenneth L; Sanchez, Ramon E; Shapiro-Mendoza, Carrie K; Rodriguez, Blanca R Cuevas; Simeone, Regina M; Pesik, Nicki T; Barfield, Wanda D; Ko, Jean Y; Galang, Romeo R; Perez-Padilla, Janice; Polen, Kara N D; Honein, Margaret A; Rasmussen, Sonja A; Jamieson, Denise J

    2016-01-01

    Zika virus is a flavivirus transmitted primarily by Aedes species mosquitoes. Increasing evidence links Zika virus infection during pregnancy to adverse pregnancy and birth outcomes, including pregnancy loss, intrauterine growth restriction, eye defects, congenital brain abnormalities, and other fetal abnormalities (1,2). The virus has also been determined to be sexually transmitted.* Because of the potential risks associated with Zika virus infection during pregnancy, CDC has recommended that health care providers discuss prevention of unintended pregnancy with women and couples who reside in areas of active Zika virus transmission and do not want to become pregnant.(†) However, limitations in access to contraception in some of these areas might affect the ability to prevent an unintended pregnancy. As of March 16, 2016, the highest number of Zika virus disease cases in the United States and U.S. territories were reported from Puerto Rico.(§) The number of cases will likely rise with increasing mosquito activity in affected areas, resulting in increased risk for transmission to pregnant women. High rates of unintended and adolescent pregnancies in Puerto Rico suggest that, in the context of this outbreak, access to contraception might need to be improved (3,4). CDC estimates that 138,000 women of reproductive age (aged 15-44 years) in Puerto Rico do not desire pregnancy and are not using one of the most effective or moderately effective contraceptive methods,(¶)(,)** and therefore might experience an unintended pregnancy. CDC and other federal and local partners are seeking to expand access to contraception for these persons. Such efforts have the potential to increase contraceptive access and use, reduce unintended pregnancies, and lead to fewer adverse pregnancy and birth outcomes associated with Zika virus infection during pregnancy. The assessment of challenges and resources related to contraceptive access in Puerto Rico might be a useful model for other areas with active transmission of Zika virus. PMID:27031817

  10. Postpartum Contraception: a Comparative Study of Berlin Women with and without Immigration Background

    PubMed Central

    David, M.; Brenne, S.; Breckenkamp, J.; Razum, O.; Borde, T.

    2015-01-01

    Research Questions: Are there differences in postpartum contraceptive use between women with and without immigration background? Do women more commonly use contraception following a high-risk pregnancy or caesarean section? What role does current breastfeeding play and, amongst immigrants, what is the effect of acculturation level on the frequency of contraceptive use? Study Population and Methods: Data collection was carried out as part of a larger study in three Berlin delivery units using standardised interviews (questionnaires covering e.g. sociodemographics, immigration history/acculturation and use of antenatal care); telephone interviews comprising 6 questions on postpartum contraception, breastfeeding and postpartum complications were conducted on a sample of the study population six months after delivery. Results: 247 women with, and 358 women without a background of immigration were included in the study (total study population n = 605, response rate 81.1 %). 68 % of 1st generation immigrants, 87 % of 2nd/3rd generation women and 73 % of women without immigration background (non-immigrants) used contraception. In the logistical regression analysis 1st generation immigrants were less likely than non-immigrants to be using contraception six months postpartum, and 1st generation immigrants with low acculturation level were significantly less likely to use contraception than 2nd/3rd generation women with low acculturation level. Conclusion: In the extended postpartum period there was no major difference in contraceptive use between immigrants in general and non-immigrants. It remains unclear whether the differing contraceptive behaviour of 1st generation immigrants is the result of less access to information, sociocultural factors or differing contraceptive requirements and further targeted, qualitative study is required. PMID:26500367

  11. Contraceptive Method Selection by Women with Inflammatory Bowel Diseases: A Cross-sectional Survey

    PubMed Central

    Gawron, Lori M.; Gawron, Andrew J.; Kasper, Amanda; Hammond, Cassing; Keefer, Laurie

    2014-01-01

    Objective Women with inflammatory bowel diseases (IBD) utilize contraception at a lower rate than the general population. We sought to identify factors associated with contraceptive use and selection of more effective methods in IBD patients at risk for unintended pregnancy. Study Design An online survey was distributed to women with IBD in January 2013. Contraceptive methods were categorized by effectiveness and associations with use explored by demographics, disease characteristics, and reproductive goals. Results 162 respondents were analyzed: 62% had Crohns disease and 38% ulcerative colitis. Mean age was 31 (range 2045), 97% identified as White, and 53% were nulliparas. 74% were currently using IBD medications. A quarter of participants (23%) used no contraception, 17% used highly effective methods, 41% used short-term hormonal methods, and 19% chose barrier/behavioral methods. Prior IBD-related surgery, biologic therapy use, and low education attainment were associated with no contraception use. Of contraceptive users, age, parity, insurance status, IBD surgery and prior immunomodulator use were associated with highly effective method selection. Conclusions A quarter of women with IBD at-risk for pregnancy in this study population reported no contraceptive method use. Higher levels of IBD activity influence contraceptive use and method selection, which could guide future patient and provider educational interventions. Implications Pregnancy planning is important for women with inflammatory bowel diseases to avoid adverse outcomes in a disease-poor state. Use of contraception assists in avoidance of unintended pregnancy. IBD characteristics are targets for educational interventions to improve uptake of highly effective contraceptive methods. PMID:24486008

  12. From abortion to contraception: Tbilisi, 1990.

    PubMed

    David, H P

    1991-01-01

    Hoping to provide women other choice besides abortion as a way to regulate fertility, 220 experts from 27 mostly European countries met in Tbilisi, Georgia, USSR to discuss ways of increasing access to modern contraceptives. Held last October, the conference was sponsored by the United Nations Population Fund (UNFPA), the World Health Organization European Regional Office (WHO/EURO), the International Planned Parenthood Federation/Europe, and the Zhordania Institute of Human Reproduction, Tbilisi. The meeting produced the Tbilisi Declaration, which -- among other things -- recognizes that unwanted pregnancies and unsafe abortions pose a serious health and social problem. Criminalization, the experts agreed, does little to reduce the number of abortions, and only increases the number of unsafe operations. The Tbilisi Declaration also affirms women's right to decide freely on the number and spacing of children, their right to reproductive health, their right to self-determination in their sexual and reproductive lives, and the right of every child to be a wanted child. The participants addressed the high incidents of abortion in some European countries -- particularly the Soviet Union. With the highest rate of abortion in Europe, the Soviet Union recorded 6 million legal abortions in 1988, and estimates that another 6 million were performed illegally. Nonetheless, perestroika has begun to facilitate access to contraceptives. Participants also discussed new methods of early pregnancy termination, RU486 and menstrual regulation procedures (MR), neither of which is readily available. Increasing access to these methods would help reduce suffering and unnecessary deaths. PMID:12283600

  13. ERICA: sexual initiation and contraception in Brazilian adolescents

    PubMed Central

    Borges, Ana Luiza Vilela; Fujimori, Elizabeth; Kuschnir, Maria Cristina Caetano; Chofakian, Christiane Borges do Nascimento; de Moraes, Ana Júlia Pantoja; Azevedo, George Dantas; dos Santos, Karine Ferreira; de Vasconcellos, Mauricio Teixeira Leite

    2016-01-01

    ABSTRACT OBJECTIVE To estimate the prevalence of sexual initiation and contraceptive use at the last sexual intercourse of Brazilian adolescents, according to sociodemographic features. METHODS The data were obtained from the Study of Cardiovascular Risks in Adolescents (ERICA), a national school-based cross-sectional study. We included 74,589 adolescents from 32 geographic strata (27 capitals and five sets of municipalities with more than 100,000 inhabitants of each of the five macro-regions of the Country). Information on sexual initiation and contraceptive use at the last sexual intercourse (male condom and oral contraceptive pill) has been used. We have estimated prevalence and confidence intervals (95%CI) considering sample weights according to sex, age, type of school, residence status, macro-region and capitals. RESULTS We observed that 28.1% (95%CI 27.0-29.2) of the adolescents had already initiated sexual life, with higher prevalence among those aged 17 years (56.4%, 95%CI 53.9-58.9), males (33.5%, 95%CI 31.8-35.2), studying at public schools (29.9%, 95%CI 28.5-31.4), and from the Northern region (33.9%, 95%CI 32.3-35.4), mainly from Macapa, Manaus, and Rio Branco. Among those who had started their sexual life, 82.3% (95%CI 81.1-83.4) reported the use of contraceptive methods at the last intercourse, and the prevalence of use was higher among adolescents aged 17 years (85.3%, 95%CI 82.7-87.6), females (85.2%, 95%CI 83.8-86.5) and those living in the Southern region (85.9%, 95%CI 82.9-88.5). Male condom was used by 68.8% (95%CI 66.9-70.7), with no difference by type of school or macro-regions; the contraceptive pill was used by 13.4% (CI95% 12.2-14.6), and more frequently used among women (24.7%, 95%CI 22.5-27,0) and 17-year-old adolescents (20.8%, 95%CI 18.2-23.6) from urban settings(13.7%, 95%CI 12.5-14.9) and from the Southern region (22.6%, 95%CI 19.0-26.8), and less often in the Northern region. CONCLUSIONS ERICA’s data analysis on sexuality and contraception shows heterogeneities in the prevalence of sexual initiation and use of contraceptive methods among Brazilian adolescents, depending on their age, where they live, and the type of school they study at. Younger adolescents and those living in the Northern region seem to be more vulnerable to the consequences of unprotected sexual intercourses. PMID:26910547

  14. ERICA: sexual initiation and contraception in Brazilian adolescents.

    PubMed

    Borges, Ana Luiza Vilela; Fujimori, Elizabeth; Kuschnir, Maria Cristina Caetano; Chofakian, Christiane Borges do Nascimento; Moraes, Ana Júlia Pantoja de; Azevedo, George Dantas; Santos, Karine Ferreira Dos; Vasconcellos, Mauricio Teixeira Leite de

    2016-02-01

    OBJECTIVE To estimate the prevalence of sexual initiation and contraceptive use at the last sexual intercourse of Brazilian adolescents, according to sociodemographic features. METHODS The data were obtained from the Study of Cardiovascular Risks in Adolescents (ERICA), a national school-based cross-sectional study. We included 74,589 adolescents from 32 geographic strata (27 capitals and five sets of municipalities with more than 100,000 inhabitants of each of the five macro-regions of the Country). Information on sexual initiation and contraceptive use at the last sexual intercourse (male condom and oral contraceptive pill) has been used. We have estimated prevalence and confidence intervals (95%CI) considering sample weights according to sex, age, type of school, residence status, macro-region and capitals. RESULTS We observed that 28.1% (95%CI 27.0-29.2) of the adolescents had already initiated sexual life, with higher prevalence among those aged 17 years (56.4%, 95%CI 53.9-58.9), males (33.5%, 95%CI 31.8-35.2), studying at public schools (29.9%, 95%CI 28.5-31.4), and from the Northern region (33.9%, 95%CI 32.3-35.4), mainly from Macapa, Manaus, and Rio Branco. Among those who had started their sexual life, 82.3% (95%CI 81.1-83.4) reported the use of contraceptive methods at the last intercourse, and the prevalence of use was higher among adolescents aged 17 years (85.3%, 95%CI 82.7-87.6), females (85.2%, 95%CI 83.8-86.5) and those living in the Southern region (85.9%, 95%CI 82.9-88.5). Male condom was used by 68.8% (95%CI 66.9-70.7), with no difference by type of school or macro-regions; the contraceptive pill was used by 13.4% (CI95% 12.2-14.6), and more frequently used among women (24.7%, 95%CI 22.5-27,0) and 17-year-old adolescents (20.8%, 95%CI 18.2-23.6) from urban settings(13.7%, 95%CI 12.5-14.9) and from the Southern region (22.6%, 95%CI 19.0-26.8), and less often in the Northern region. CONCLUSIONS ERICA's data analysis on sexuality and contraception shows heterogeneities in the prevalence of sexual initiation and use of contraceptive methods among Brazilian adolescents, depending on their age, where they live, and the type of school they study at. Younger adolescents and those living in the Northern region seem to be more vulnerable to the consequences of unprotected sexual intercourses. PMID:26910547

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

    PubMed Central

    2010-01-01

    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

  16. Emergency contraception - Potential for women's health

    PubMed Central

    Mittal, Suneeta

    2014-01-01

    Emergency contraception (EC) is a safe and effective method which is used to prevent unwanted pregnancy after unprotected sexual intercourse. Many of the unwanted pregnancies end in unsafe abortions. The search for an ideal contraceptive, which does not interfere with spontaneity or pleasure of the sexual act, yet effectively controls the fertility, is still continuing. Numerous contraceptive techniques are available, yet contraceptive coverage continues to be poor in India. Thus, even when not planning for a pregnancy, exposure to unprotected sex takes place often, necessitating the use of emergency contraception. This need may also arise due to failure of contraceptive method being used (condom rupture, diaphragm slippage, forgotten oral pills) or following sexual assault. Emergency contraception is an intervention that can prevent a large number of unwanted pregnancies resulting from failure of regular contraception or unplanned sexual activity, which in turn helps in reducing the maternal mortality and morbidity due to unsafe abortions. However, a concern has been expressed regarding repeated and indiscriminate usage of e-pill, currently the rational use of emergency contraception is being promoted as it is expected to make a significant dent in reducing the number of unwanted pregnancies and unsafe abortions. In fact, since the introduction of emergency contraception, the contribution of unsafe abortion towards maternal mortality has declined from 13 to 8 per cent. PMID:25673542

  17. Contraceptive choices--turning back the clock.

    PubMed

    Weisberg, E

    1991-01-01

    Contraceptive choices are being reduced rather than being expanded in many parts of the world, particularly in Western countries. Although this paper presents an Australian perspective, the concerns are shared by family planners in other countries. The reasons for this are multiple and complex and often interrelated but ultimately depend on commercial considerations. The community expectation is that an ideal contraceptive can and does exist, but the media sensationalization of contraceptive problems has given many contraceptive methods a poor image. Contraceptive availability is also affected by liability issues, which have increased the cost of product liability insurance, and medical liability insurance of health professionals, increasing both the cost of contraceptives to the individual and the availability of services such as IUD insertions and sterilization, as practitioners withdraw their services, due to cost of insurance. The cost of marketing a new contraceptive from the time the idea is first developed until it is approved for marketing also deters manufacturers from developing new contraceptives. Delays in drug evaluation procedures in many countries deters companies with already well established contraceptives from marketing them in such countries. The effect of political stands by radical feminists or consumer groups, also effect both the image and the availability of contraceptives, as can be seen with the saga of Depo-Provera, RU486 and intrauterine devices. Similarly, the moral perceptions of anti-abortion groups and health care providers is also a threat to fertility control services. Possible solutions to some of these problems are offered in the paper. PMID:1950710

  18. Early partial hydatidiform mole: prevalence, histopathology, DNA ploidy, and persistence rate.

    PubMed

    Fukunaga, M

    2000-08-01

    The widespread use of ultrasound in the diagnosis and management of intrauterine fetal death has resulted in moles being evacuated earlier than before. In order to clarify clinicopathologic features of early partial mole (PM), morphology and DNA ploidy of early (< or =12 gestational weeks) and late (>12 gestational weeks) partial PM were studied. A total of 80 early and 20 late PMs (37 from 1981-90; 63 from 1991-98) were analyzed. Mean gestational ages were 9.6 weeks for early PMs and 14.8 weeks for late PMs. Early PM was more common in 1991-1998 (57/63, 90%) than in 1981-1990 (23/37, 62%). Pre-evacuation diagnosis of hydatidiform mole was achieved in only 4 early and 1 late PMs. There were no significant differences in histology between early and late PMs, except that villi were smaller in early PMs and there was extensive stromal fibrosis in late PMs. Ploidy was as follows: 70 of 80 early PMs and 19 of 20 late PMs were triploid, 5 early PMs were aneuploid, and 5 early and 1 late PM were diploid. None of 45 patients with early PM and 1 of 11 with late triploid PM developed persistent gestational trophoblastic disease. Early PM is now more prevalent than it was previously. This may be a result of greater awareness of the entity of PM, its increased recognition by pathologists and the widespread use of ultrasound in the diagnosis and management of intrauterine fetal death. The diagnosis of PM should be based on pathological examination, since most PMs still elude clinical detection. DNA ploidy analysis is useful in the evaluation of problem cases. The risk of persistent disease seems to be very low in the case of early PMs. PMID:10993279

  19. The outcome of the primary vascular access and its translation into prevalent access use rates in chronic haemodialysis patients

    PubMed Central

    Praehauser, Claudia; Breidthardt, Tobias; Moser-Bucher, Cora Nina; Wolff, Thomas; Baechler, Katrin; Eugster, Thomas; Dickenmann, Michael; Gurke, Lorenz; Mayr, Michael

    2012-01-01

    Background The American Fistula First Breakthrough Initiative currently aims for a 66% arterio-venous fistula (AVF) rate, while in the UK, best practice tariffs target AVF and arterio-venous graft (AVG) rates of 85%. The present study aims to assess whether these goals can be achieved. Methods We conducted a retrospective cohort study on patients who initiated haemodialysis from 1995 to 2006. Outcomes were the final failure-free survival of the first permanent access and the type of second access created. Prevalent use rates for the access types were calculated on the 1st January of each year for the second half of the study period. Results Two hundred and eleven out of 246 patients (86%) received an AVF, 16 (6%) an AVG and 19 (8%) a permanent catheter (PC) as the first permanent access. Eighty-six (35%) patients had final failure of the primary access. One- and 3-year final failure-free survival rates were 73 and 65% for AVF compared with 40 and 20% for AVG and 62 and 0% for PC, respectively. In patients with primary AVF, female sex {hazard ratio (HR) 2.20 [confidence interval (CI) 1.29–3.73]} and vascular disease [HR 2.24 (CI 1.26–3.97)] were associated with a poorer outcome. A similar trend was observed for autoimmune disease [HR 2.14 (CI 0.99–4.65)]. As second accesses AVF, AVG and PC were created in 47% (n = 40), 38% (n = 33) and 15% (n = 13). The median prevalent use rate was 80.5% for AVF, 14% for AVG and 5.5% for PC. Conclusions The vascular access targets set by initiatives from the USA and UK are feasible in unselected haemodialysis patients. High primary AVF rates, the superior survival rates of AVFs even in patient groups at higher risk of access failure and the high rate of creation of secondary AVFs contributed to these promising results. PMID:25874094

  20. Committee Opinion No. 642: Increasing Access to Contraceptive Implants and Intrauterine Devices to Reduce Unintended Pregnancy.

    PubMed

    2015-10-01

    Unintended pregnancy persists as a major public health problem in the United States. Although lowering unintended pregnancy rates requires multiple approaches, individual obstetrician-gynecologists may contribute by increasing access to contraceptive implants and intrauterine devices. Obstetrician-gynecologists should encourage consideration of implants and intrauterine devices for all appropriate candidates, including nulliparous women and adolescents. Obstetrician-gynecologists should adopt best practices for long-acting reversible contraception insertion. Obstetrician-gynecologists are encouraged to advocate for coverage and appropriate payment and reimbursement for every contraceptive method by all payers in all clinically appropriate circumstances. PMID:26393458

  1. Increasing Use of Long-Acting Reversible Contraception to Decrease Unplanned Pregnancy.

    PubMed

    Lotke, Pamela S

    2015-12-01

    Unintended pregnancy remains high in the United States, accounting for one-half of pregnancies. Both contraceptive nonuse and imperfect use contribute to unplanned pregnancies. Long-acting reversible contraception (LARC) have greater efficacy than shorter acting methods. Data from large studies show that unplanned pregnancy rates are lower among women using LARC. However, overall use of LARC is low; of the reproductive age women using contraception, less than 10% are LARC users. Barriers include lack of knowledge and high up-front cost, and prevent more widespread use. Overcoming these barriers and increasing the number of women using LARC will decrease unplanned pregnancies and abortions. PMID:26598299

  2. The return of fertility after discontinuation of oral contraception in Malaysian women.

    PubMed

    Hassan, J; Kulenthran, A; Thum, Y S

    1994-12-01

    The return of fertility after discontinuation of oral contraception was studied in a cross-sectional survey of 61 patients who were desirous of a further pregnancy. For controls, 380 women who did not take any oral contraception were used. Cumulative conception rates in the pill users were reduced but not significantly during the first three (p = 0.15) and six months (p = 0.20). By 12 months this difference was negligible (p = 0.28). We conclude that there is no significant delay in return of fertility following cessation of oral contraception in our group of Malaysian women. PMID:7674970

  3. Associations Between Abortion Services and Acceptance of Postabortion Contraception in Six Indian States.

    PubMed

    Banerjee, Sushanta K; Gulati, Sumit; Andersen, Kathryn L; Acre, Valerie; Warvadekar, Janardan; Navin, Deepa

    2015-12-01

    Women receiving induced abortions or postabortion care are at high risk of subsequent unintended pregnancy, and intervals of less than six months between abortion and subsequent pregnancy may be associated with adverse outcomes. This study highlights the prevalence and attributes of postabortion contraceptive acceptance from 2,456 health facilities in six major Indian states, among 292,508 women who received abortion care services from July 2011 through June 2014. Eighty-one percent of the women accepted postabortion contraceptive methods: 53 percent short-term, 11 percent intrauterine devices, and 16 percent sterilization. Postabortion contraceptive acceptance was highest among women who were aged 25 years and older, received first-trimester services, received induced abortion, attended primary-level health facilities, and had medical abortions. Doctors receiving post-training support were more likely to offer contraceptives, but no association was observed between such support and acceptance of IUDs or sterilization. Comprehensive service-delivery interventions, including ensuring availability of skilled providers and contraceptive commodities, offering clinical mentoring for providers, identifying and addressing provider bias, and improving provider counseling skills, can increase postabortion contraceptive acceptance and reduce unintended pregnancy. PMID:26643489

  4. Elevated rates of current PTSD among Hispanic veterans in the NVVRS: true prevalence or methodological artifact?

    PubMed

    Lewis-Fernández, Roberto; Turner, J Blake; Marshall, Randall; Turse, Nicholas; Neria, Yuval; Dohrenwend, Bruce P

    2008-04-01

    The elevated rate of current posttraumatic stress disorder (PTSD) among Hispanic Vietnam veterans has been attributed to culturally based expressiveness that inflates symptom self-reports. To investigate this possibility, the authors conducted three hypothesis-driven analyses with National Vietnam Veterans Readjustment Study (NVVRS) data from the Structured Clinical Interview for DSM-III-R (SCID-) diagnosed subsample of male Vietnam Theater veterans (N = 260). First, persistence of the Hispanic elevation after adjusting for war-zone stress exposure initially suggested the effect of greater expressiveness. Second, symptom-based analyses isolated this effect to the self-report Mississippi Scale for Combat-Related PTSD and not to the clinician-rated SCID interview. Third, objective measures of functioning did not reveal a unique Hispanic pattern of lower impairment associated with current PTSD. These tests suggest that greater Hispanic expressiveness does not account for the Hispanic elevation in current PTSD in the NVVRS SCID-diagnosed subsample. PMID:18404629

  5. Choosing and using contraception: toward a theory of women's contraceptive self-care.

    PubMed

    Lethbridge, D J

    1991-01-01

    Thirty women of varying ethnicity and socioeconomic status, who were actively seeking to avoid pregnancy, were interviewed concerning their lifetime experience with contraceptive use. The resulting description, Women's Contraceptive Self-Care, was divided into four processes: the central process, Choosing and Using Contraception, and three contextual processes. Forestalling Pregnancy was defined as using contraceptive methods or behaviors to prevent or delay childbearing. Assigning the Burden of Contraceptive Responsibility was defined as assuming responsibility for contraception or shifting that responsibility to a partner. Negotiating with Those who Control Contraception was defined as maneuvering among individuals and agencies that permit or hinder access to contraceptive methods and behaviors. Each process is comprised of thematic clusters and/or themes that are defined and illustrated. PMID:1896325

  6. Contraception and the adolescent diabetic.

    PubMed

    Fennoy, I

    1989-01-01

    We believe our data suggests that pregnancy among adolescent diabetics is more frequent than would be expected from the general population at a time when diabetic control is at its worse. Thus patients and their offspring are exposed to extreme morbidity. Current recommendations regarding contraception in patients with diabetes are not appropriate for the adolescent population and therefore tend to support this phenomenon rather than relieve it. Because of the peculiar physiological and developmental characteristics of this population, more medical research is necessary regarding various hormonal preparations available to determine the safest acceptable contraceptive for the adolescent diabetic. To be truly effective, these new alternatives must be presented to the patient in the context of a counseling program that (1) recognizes that this population does have an unusually high frequency of pregnancy for reasons unknown, and that (2) stresses the need for the patient to take control of the diabetes prior to becoming pregnant. PMID:2516509

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

    PubMed Central

    Khan, Usman; Nicell, Jim A.

    2014-01-01

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

  8. FPIA helps expand contraceptive services.

    PubMed

    Groot, H

    1984-01-01

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

  9. Self-rated chronic conditions and 2-week prevalence in adults in Zhongshan, China: an epidemiological survey

    PubMed Central

    Zhu, Chunyan; Sun, Xiaomin; Geng, Qingshan; Fu, Rong; Yang, Hongling; Jiang, Wei

    2015-01-01

    Objective To examine the association between behavioural factors and the risk of chronic conditions and 2-week prevalence. Design This was a cross-sectional survey. Setting The study was conducted in Zhongshan, China. Participants A multistage clustering sampling method was used to select a representative sample of residents from the household registration system between July and September 2011. The overall sample replacement rate was 9.4%, and the final sample included 43 028 individuals. Outcome measures Chronic conditions and 2-week prevalence. Results 4979 (11.6%) of the participants reported having at least one chronic condition, 1067 (2.5%) had two or more concurrent chronic conditions, and 6830 (15.9%) reported having at least one disease in a 2-week recall period. The most common chronic condition was primary hypertension, which was reported by 6.8% of participants. Logistic regression models demonstrated that the main factors for having a chronic condition and 2-week prevalence were older age (≥65 years of age; OR 44.91, 95% CI 33.05 to 61.03; and OR 12.71, 95% CI 10.44 to 15.46, respectively), obesity (OR 3.00, 95% CI 2.63 to 3.42; and OR 2.50, 95% CI 2.22 to 2.82, respectively) and being a former smoker (OR 3.02, 95% CI 2.54 to 3.58; and OR 3.24, 95% CI 2.74 to 3.82, respectively). Conclusions This study suggests that older age, obesity and unhealthy behaviours are high-risk factors for poorer health status among the residents of Zhongshan, China. The present findings highlight the importance of recognising and managing harmful behaviours in order to improve health. PMID:26560055

  10. Opposing views on contraceptives presented.

    PubMed

    This article presents two opposing views on the importance of artificial contraceptives. It is noted that in the April 19 issue of the Manila Bulletin, Ms. Ethel Soliven wrote in her column that the position of the Catholic Church on artificial contraceptives is standing in the way of success of the Philippine family planning campaign. To this effect, Sister Mary Pilar Versoza of the Religious of the Good Shepherd, sent a letter of rebuttal saying that the church has never been remiss in emphasizing the true meaning of sexual act, love and relationship, marriage, and family responsibilities. Sister Pilar contended that ligation and condoms do not solve husbands¿ selfishness. In response, Soliven argued in another issue of the Manila Bulletin that she believes in the need to provide access to artificial contraceptives. Soliven asserted that destitute couples who cannot provide their families with even the barest necessities of life should be provided with the means with which to prevent unwanted pregnancies. PMID:12322661

  11. Depo-provera: contraceptive risk?

    PubMed

    Rosenfield, A

    1980-04-01

    This writer agrees with Carol Levine that the issue involving depo-provera is both complex and confusing. Comment is offered on some of the conclusions reached by Levine in her article, "Depo-Provera and Contraceptive Risk: A Case Study of Values and Conflicts". In the discussion of risks and benefits, problems with administration of estrogens are rarely recommended for depo-provera users. The metabolic side-effects which are identified are also seen among oral contraceptive (OC) users and, with the exception of weight gain, appear to have a smaller impact than the combination oral steroids. Exception is taken with the description of delayed return of fertility as a "particularly serious side-effect," for delay in return appears to be a matter of months only. In regard to carcinogenicity, there is no statistically valid evidence of danger relating depo-provera to breast or cervical cancer in the human. Levine's article gives the impression that depo-provera is intended for poor women or "2nd class" citizens and this fails to accurately reflect what probably would occur were the drug available in the United States. This writer believes depo-provera to be a safer contraceptive method than the OC and to be more effective in practice. PMID:6445344

  12. Sex differences in conditioned stimulus discrimination during context-dependent fear learning and its retrieval in humans: the role of biological sex, contraceptives and menstrual cycle phases

    PubMed Central

    Lonsdorf, Tina B.; Haaker, Jan; Schümann, Dirk; Sommer, Tobias; Bayer, Janine; Brassen, Stefanie; Bunzeck, Nico; Gamer, Matthias; Kalisch, Raffael

    2015-01-01

    Background Anxiety disorders are more prevalent in women than in men. Despite this sexual dimorphism, most experimental studies are conducted in male participants, and studies focusing on sex differences are sparse. In addition, the role of hormonal contraceptives and menstrual cycle phase in fear conditioning and extinction processes remain largely unknown. Methods We investigated sex differences in context-dependent fear acquisition and extinction (day 1) and their retrieval/expression (day 2). Skin conductance responses (SCRs), fear and unconditioned stimulus expectancy ratings were obtained. Results We included 377 individuals (261 women) in our study. Robust sex differences were observed in all dependent measures. Women generally displayed higher subjective ratings but smaller SCRs than men and showed reduced excitatory/inhibitory conditioned stimulus (CS+/CS−) discrimination in all dependent measures. Furthermore, women using hormonal contraceptives showed reduced SCR CS discrimination on day 2 than men and free-cycling women, while menstrual cycle phase had no effect. Limitations Possible limitations include the simultaneous testing of up to 4 participants in cubicles, which might have introduced a social component, and not assessing postexperimental contingency awareness. Conclusion The response pattern in women shows striking similarity to previously reported sex differences in patients with anxiety. Our results suggest that pronounced deficits in associative discrimination learning and subjective expression of safety information (CS− responses) might underlie higher prevalence and higher symptom rates seen in women with anxiety disorders. The data call for consideration of biological sex and hormonal contraceptive use in future studies and may suggest that targeting inhibitory learning during therapy might aid precision medicine. PMID:26107163

  13. Antidepressant treatment of premature ejaculation: discontinuation rates and prevalence of side effects for dapoxetine and paroxetine in a naturalistic setting.

    PubMed

    Jern, P; Johansson, A; Piha, J; Westberg, L; Santtila, P

    2015-01-01

    The present study aimed to investigate prevalence of and reasons for selective serotonin reuptake inhibitor (SSRI) discontinuation, and compare the two most common SSRIs used in premature ejaculation (PE) treatment, in naturalistic settings (that is, outside clinical trials). The sample consisted of 132 Finnish men with a mean age of 42.5 years (s.d. = 10.6) who had received medical treatment for lifelong PE. The men were enlisted for the study after identifying individuals from the third author's (a physician specializing in sexual medicine) patient registry. Participants responded to a secure, online questionnaire. PE treatment-related side effects of, and discontinuation rates for, different SSRIs were retrospectively self-reported. Treatment efficacy and happiness with treatment were retrospectively self-assessed. Discontinuation rates were uniformly high, ranging from 28.8 to 70.6% between different SSRIs. Dapoxetine was associated with the highest dropout rates (70.6%), and paroxetine the lowest, discontinuation rates. Limited efficacy and side effects were the most common reasons for discontinuation. Paroxetine was more effective and better tolerated than dapoxetine. A considerable number of patients chose to spontaneously discontinue treatment, especially so in the case of dapoxetine, corroborating recent studies conducted in naturalistic settings. Further research efforts are necessary to develop new and improve existing PE treatment alternatives. PMID:25410962

  14. Premenstrual Syndrome Symptomatology among Married Women of Fertile Age based on Methods of Contraception (Hormonal versus Non-Hormonal Methods of Contraception)

    PubMed Central

    Bakhshani, Nour Mohammad; Hosseinbor, Mohsen; Shahraki, Zahra; Sakhavar, Nahid

    2014-01-01

    Introduction: Premenstrual syndrome (PMS) refers to the cyclic occurrence of a set of disturbing physical, emotional or behavioral alterations that are of sufficient severity to interfere with interpersonal relations and routine life. Normal variations in gonadal estrogen and progesterone lead to biochemical reactions in the brain, resulting in PMS symptoms. This study aims to investigate the prevalence of PMS and PMDD signs among married women of fertile age (MWFA) based on the methods of birth control. Method and Materials: In a descriptive study, a number of 400 married women referring to 20 family healthcare clinics that use contraceptive methods were recruited and PMS questionnaire were administered to them. Results: From 400 subjects, 205 took oral contraceptive pills (hormonal methods of contraception) and 195 used other birth control methods (non-hormonal method). A number of 345 subjects (86.25%) at least experienced one PMS symptom and 55 subjects (13.75%) did not report any symptoms. Of those who use hormonal contraceptives (HCs), 182 (88.8%) reported PMS symptoms and 23(11.2) lacked any symptoms. Conclusion: About 86% of the subjects showed moderate to severe of PMS symptoms. Although using hormonal contraceptive method can theoretically reduce PMS symptoms, such effect was not observed in this study. The results of this research should be generalized with caution. Future studies are suggested. PMID:24576370

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

    ERIC Educational Resources Information Center

    Hansen, Thomas; Skjeldestad, Finn Egil

    2003-01-01

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

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

    ERIC Educational Resources Information Center

    Hansen, Thomas; Skjeldestad, Finn Egil

    2003-01-01

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

  17. [Contraception for women taking antiepileptic drugs].

    PubMed

    Reiter, Lillian; Nakken, Karl O

    2016-01-12

    Most women of fertile age want safe contraception. This is especially important for women with epilepsy, as some antiepileptic drugs may have harmful effects on the foetus. When hormonal contraception is combined with antiepileptic drugs, it is essential to be aware that certain antiepileptic drugs may reduce the efficacy of hormonal contraceptives and vice versa, which may result in a reduced effect for both drugs. Non-hormonal contraception, such as the copper coil and barrier methods may, however, be used safely in this patient group. PMID:26757657

  18. [Prevalence, incidence rate and structure of congenital and hereditary forms of ENT diseases in population of Azerbaijan Republic].

    PubMed

    Panakhian, V M

    2005-01-01

    The primary field study in Azerbaijan Republic (AR) aimed at registration of the prevalence, incidence rate and structure of congenital and hereditary forms of ENT diseases in population of the AR. A total of 7725 patients with the above diseases were registered. The phenotyping frequency of ENT pathology was 94 patients per 100,000. The highest morbidity was documented for deafness (3571, 47.5%) and hypoacusis (3025, 39.1%), the least--for congenital laryngeal pathology (2, 0.026%). Congenital and hereditary ENT diseases occurred most frequently in the population of the Lenkoran-Astarin zone, Baku and Baku Region, among refugees, least frequently--in the population of Kuba-Khachmass, Shirvan and Central Aran zones. PMID:16034345

  19. Post-marketing surveillance of Norplant contraceptive implants: I. Contraceptive efficacy and reproductive health.

    PubMed

    2001-04-01

    The subject of this study to examine the safety and contraceptive efficacy of Norplant, we undertook a 5-year study of follow-up of women initiating use of Norplant, intrauterine device (IUD) or sterilization in eight developing countries. Women attending family clinics were enrolled if they consented and were medically eligible to use Norplant, IUD, or female sterilization. Women who chose to initiate use of IUDs or surgical sterilization served as controls and were frequency matched in 5-year age-bands with women who chose to use Norplant. At admission women had a physical examination, and their medical histories, demographic, and socio-economic characteristics were recorded. Follow-up visits were scheduled in the first 6 weeks after admission and semi-annually thereafter for 5 years irrespective of change of contraceptive method. Incidence rate ratios of health events were estimated for initial and current contraceptive method use. This paper reports reproductive health events and contraceptive efficacy. Altogether, 7,977 women initiating use of Norplant, 6,625 of IUD, and 1,419 of surgical sterilization were admitted. Their mean ages at initiation were 28.5, 28.5, and 29.6 years, respectively. More than 99% were married or cohabiting, and parous. Five-year follow-up was completed by 94.6% of the women. By the end of 5 years, the mean duration of first segment use per initiator was 4.16 years for Norplant, 4.10 years for IUDs, and 4.96 years for sterilization accounting for 39,337 woman-years for Norplant, 31,915 for IUDs, and 7,071 for sterilization. The study accumulated 78,323 woman-years of observation. Pearl pregnancy rates for Norplant, copper IUDs and female sterilization were 0.27, 0.88, and 0.17 per 100 woman-years, respectively. Users of Norplant, copper IUDs, and sterilization had rates of ectopic pregnancy of 0.30, 0.68, and 0.13 per 1,000 woman-years, respectively. Major health events related to the reproductive system were rare. Rates of acute PID were significantly lower among Norplant users than IUD users (p = 0.004). The rate of ovarian enlargement was significantly higher in Norplant users than controls (p <0.001), but not rates of hospitalization for this condition. Vaginitis and vaginal discharge, and low abdominal pain were significantly less frequent in Norplant users than in the other groups. Bleeding disturbances were more frequent among Norplant users than controls but not anemia. The study confirms the high contraceptive efficacy of Norplant, copper IUDs, and female sterilization. The incidence rates of major reproductive health problems were low. There was no significant excess of serious reproductive morbidity among users of Norplant compared to users of IUDs and sterilization. PMID:11376646

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

    PubMed Central

    Taylor, Brent; Jick, Hershel; MacLaughlin, Dean

    2013-01-01

    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

  1. The newly-weds' decisions on contraception.

    PubMed

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

    1992-01-01

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

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

    PubMed

    Ybarra, Michele L; Mitchell, Kimberly J

    2013-12-01

    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

  3. A subdermal progestin implant for long-term contraception.

    PubMed

    1991-03-01

    The report synthesizes the significant information on the Norplant System (Wyeth-Ayerst) for long term contraception in terms of delivery, pharmacokinetics, mechanism of action, and effectiveness. Levonorgestrel (36 mg) in each six capsules is sealed into 2.4 x 34 mm cylindrical capsules made of "Silastic" a siloxane copolymer and implanted subdermally in the inside arm through a 2 mm incision. The slow diffusion of progestin into the bloodstream provides sufficient contraception up to 5 years. 80-85 mcg of levonorgestrel are released daily in the 1st year, and thereafter 30-35 mcg daily which is similar to oral progestin only dosage. Levonorgestrel is metabolized in the liver more slowly than endogenous progestin. The drug is eliminated from the plasma 5 - 14 days after removal. Exogenous progestin acts to decrease secretion of the gonadotropins FSH and LH. If ovulation occurs, progestin induced thick scanty mucus prevents sperm migration. Endometrial development and growth is suppressed, and perhaps progesterone secretion during the luteal phase. The failure rate was 4-5/1000 user/year, compared to the oral contraceptive rate of 20-50/1000 year. However, for women weighing 70 kg or more the rate increases to 8.5/100 users over a 5 year period. Concurrent usage of phenytoin or carbamazepine may increase the failure rate. After implant removal, 50% became pregnant within 3 months, and 86% within this year. PMID:1899898

  4. The Role of Quality Health Services and Discussion about Birth Spacing in Postpartum Contraceptive Use in Sindh, Pakistan: A Multilevel Analysis

    PubMed Central

    Tappis, Hannah; Dahar, Zaib; Ali, Anayat; Agha, Sohail

    2015-01-01

    Introduction Rapid population growth, stagnant contraceptive prevalence, and high unmet need for family planning present significant challenges for meeting Pakistan’s national and international development goals. Although health behaviors are shaped by multiple social and environmental factors, research on contraceptive uptake in Pakistan has focused on individual and household determinants, and little attention has been given to community characteristics that may affect access to services and reproductive behavior. Methods Individual and community determinants of contraceptive use were identified using multivariable multilevel logistic regression to analyze data from a 2014 cross-sectional survey of 6,200 mothers in 503 communities in Sindh, Pakistan. Results Only 27% of women who had given birth in the two years before the study reported using contraceptives. After adjusting for individual and community characteristics, there was no difference in the odds of contraceptive use between urban and rural women. Women who had delivered at a health facility had 1.4 times higher odds of contraceptive use than women who delivered at home. Those who received information about birth spacing from a doctor or relatives/friends had 1.81 and 1.38 times higher odds of contraceptive use, respectively, than those who did not. Living in a community where a higher proportion of women received quality antenatal care and where discussion of birth spacing was more common was significantly associated with contraceptive use. Community-wide poverty lowered contraceptive use. Conclusions Quality of care at the community level has strong effects on contraceptive use, independent of the characteristics of individual households or women. These findings suggest that powerful gains in contraceptive use may be realized by improving the quality of antenatal care in Pakistan. Community health workers should focus on generating discussion of birth spacing in the community. Outreach efforts should target communities where the demand for contraception appears to be depressed due to high levels of poverty. PMID:26485524

  5. Athletic performance and the oral contraceptive.

    PubMed

    Rechichi, Claire; Dawson, Brian; Goodman, Carmel

    2009-06-01

    Some reports suggest variation in physiological responses and athletic performance, for female athletes at specific phases of the menstrual cycle. However, inconsistent findings are common due to the inappropriate verification of menstrual cycle phase, small subject numbers, high intra- and interindividual variability in estrogen and progesterone concentration, and the pulsatile secretion of these hormones. Therefore, the oral contraceptive (OC) cycle may provide a more stable environment in which to evaluate the acute effect of reproductive hormones on physiological variables and exercise performance. To date, most of the OC research has compared differences between OC use and nonuse, and few researchers have examined within-cycle effects of the OC. It is also apparent that OC use is becoming far more prevalent in athletes; hence the effect of the different exogenous and endogenous hormonal profiles on athletic performance should be investigated. Research to date identifies potential for variation in aerobic performance, anaerobic capacity, anaerobic power and reactive strength throughout an OC cycle. The purpose of this review is to present and evaluate the current literature on the physiology of exercise and athletic performance during the OC cycle. PMID:19567919

  6. Fertile inventions: new contraceptive techniques.

    PubMed

    1984-09-01

    Research into contraception is producing new techniques that involve everything from vaccinations to nasal sprays. Steroids are the basis of the conventional contraceptive pill and much current research is on alternative ways of introducing the same drugs into the woman's reproductive system. Norplant is 1 approach. It involves implanting 6 tiny silicone-rubber tubes just beneath the skin of a woman's underarm. The tubes contain a drug, widely used as an ingredient of the contraceptive pill, which is slowly released from the tubes over a period of 5 years. It is understandable that much contraceptive research is focused on the womb. The brain, however, seems a strange place to be concerned with when trying to prevent conception. But it is the brain that controls a woman's ovulation by sending signals to the reproductive system via the pituitary gland. And now it is possible to synthesize chemicals which, when given in the form of a nasal spray, will inhibit ovulation by mimicking the brain's signals to the pituitary gland. It may even be possible to develop drugs which act directly on parts of the brain itself--a prospect we should be aware of, whether we would approve of it or not. There has been such an explosion of knowledge of the neural transmission systems that this may not be so far-fetched as it sounds. Research in China tends to concentrate more on naturally occurring substances--like a new form of female sterilization which involves not anesthetics or surgery but a substance called "mucilage"--1 of the ingredients of birds-nest soup. If mucilage is passed through the cervix into the fallopian tubes it causes them to block up and so prevents the passage of the ovum. There is a Western "high-tech" alternative to this, called methylcyanoacrylate--you might be more familiar with it as "superglue" or "crazy glue." Used carelessly it can stick your fingers together, but this tendency to join human tissues can be more productively used to block up the fallopian tubes. The Chinese are also looking at another natural substance as the basis of the possible "male pill." This is gossypol which occurs in cottonseed. A major reason why most research has been focused on contraception for women is that men present problems of quite a different order of magnitude. While a woman only ovulates once every 28 days or so, male sperm are produced continuously, with 200-400 million of them in each ejaculation. But drugs based on gossypol, which seems to have the effect of reducing the sperm count, may be the answer. Under the auspices of the World Health Organization, research on gossypol and other plants with contraceptive potential is now going on over all the world. Some 350 have been put under the microscope so far and about 30 look worth pursuing. PMID:12266504

  7. Use of depot medroxyprogesterone acetate contraception in adolescents.

    PubMed

    Davis, A J

    1996-05-01

    More than 1 million teen pregnancies occur each year in the United States. DMPA offers several distinct advantages over other contraceptive methods in adolescents. The duration of effectiveness and convenience of DMPA are appealing to teens. Most teens who are current users view amenorrhea as a positive feature of DMPA. Although most young women are able to tolerate the irregular bleeding, some find the cycle disruption concerning. Satisfaction rates among adolescent DMPA users is high. PMID:8725703

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

    PubMed

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

    2004-08-01

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

  9. The potential impact of improvements in contraception on fertility and abortion in Western countries.

    PubMed

    Westoff, C F; Hammerslough, C R; Paul, L

    1987-11-01

    Survey information on fertility intentions, patterns of contraceptive use, contraceptive failures, and abortions is used to develop estimates of unwanted births and of unplanned pregnancies for 7 countries -- Finland, France, Netherlands, Norway, Sweden, UK, and the US, by contraceptive method. European fertility is the primary focus, and the data were derived from 6 European fertility surveys selected primarily because of the inclusion of data such as fertility intentions and contraceptive-exposure status and the availability of abortion data from other sources. The US was included both for comparative purposes and to provide some of the needed information not available from the European surveys. The 1st objective was to estimate the unwanted birthrates to women who want no more births; the 2nd objective involved estimating the unplanned pregnancy rates for all women. In regard to the 1st objective, the ultimate reduction in general fertility that can be achieved by reduction of contraceptive failure is minimal, i.e., under 10%. The reductions in unwanted pregnancy rates can be realized primarily by substantial increases in the proportion of couples contraceptively sterilized and by a reduction in the nonuse of contraception. The main effect of improvements in contraceptive practice will be to reduce high abortion rates, rather than to reduce fertility. Most abortions are to women who ultimately want to have (more) children, suggesting a considerable potential for the reduction of abortions through the improvements of contraceptive practice. Reductions of 1/3 to 1/5 of abortions in the countries studied seem possible, even without new technology. The main source of such reductions lies in the adoption of any contraceptive method on the part of nonusers. For example, if all nonusers in the UK simply shifted to the least effective category -- other methods, which includes withdrawal, rhythm, and the diaphragm, with all else remaining constant, the implied reductions in abortions would be nearly 30%. The hypothetical reductions in abortions significantly underestimate the true potential impact of improvements in contraceptive practice because they do not consider teenage pregnancy. To achieve comparability across national surveys, the age group forming the highest common denominator -- ages 20-44 -- had to be selected. The proportion of abortions that are obtained by teenagers is about 1/6 in Sweden, 1/4 in Norway, and over 1/4 in the US. PMID:12280731

  10. Young Australian women explain their contraceptive choices.

    PubMed

    Wigginton, Britta; Moran, Claire; Harris, Melissa L; Loxton, Deborah; Lucke, Jayne

    2016-07-01

    New developments in female contraceptives allow women increased options for preventing pregnancy, while men's options for reversible contraception have not advanced beyond the condom. There has been little discursive exploration of how neoliberal and postfeminist discourses shape women's accounts of choosing whether or not to use contraception. Our thematic discourse analysis of 760 free-text responses to a question about contraceptive choice considers the social and political climate that promotes the self-governed woman who freely chooses contraception. We examine the ways in which women formulated and defended their accounts of choice, focusing on the theme of free contraceptive choice that constructed women's choices as unconstrained by material, social and political forces. We identify two discursive strategies that underpinned this theme: a woman's body, a woman's choice and planning parenthood, and explore the ways in which choice was understood as a gendered entitlement and how contraceptive choices were shaped (and constrained) by women's plans for parenthood. We discuss the implications of these discursive strategies, and neoliberal and postfeminist discourses, in terms of the disallowance of any contextual, social and structural factors, including the absence of men in the 'contraceptive economy'. PMID:26670866

  11. Understanding Adolescent Contraceptive Choice: An Empirical Test.

    ERIC Educational Resources Information Center

    Adler, Nancy E.; And Others

    Research using expectancy models has shown contraceptive choice among adults to be a rational process in that intentions and behaviors reflect an individual's beliefs, values, attitudes, and perceptions of social norms. This study examined whether such an approach could accurately represent adolescents' contraceptive decision-making. It used the

  12. Adolescent Contraceptive Use: Models, Research, and Directions.

    ERIC Educational Resources Information Center

    Whitley, Bernard E., Jr.; Schofield, Janet Ward

    Both the career model and the decision model have been proposed to explain patterns of contraceptive use in teenagers. The career model views contraceptive use as a symbol of a woman's sexuality and implies a clear decision to be sexually active. The decision model is based on the subjective expected utility (SEU) theory which holds that people

  13. La contraception de l'adolescente

    PubMed Central

    Pinsonneault, Odette

    1991-01-01

    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

  14. Obstacles impede development of contraceptive vaccine.

    PubMed

    1994-08-15

    Even though a contraceptive vaccine for men or women seems to be technically feasible, contraception researchers are finding that they must overcome several obstacles before a vaccine can hit the market. The considerable variation in human immune response raises doubt about a vaccine's ability to effectively protect against pregnancy in everyone. Research shows that, so far, vaccines elicit an immune response that lasts for only a limited time. A test indicating when a vaccine is losing its ability to protect against pregnancy is not on the horizon. The World Health Organization [WHO] has chosen the human chorionic gonadotropin (the female pregnancy hormone) as a target contraceptive vaccine. US researchers are concentrating on a vaccine for men based on luteinizing hormone releasing factor (LH-RF). The US-based Population Council has conducted a safety test of the LH-RF contraceptive vaccine in 4 men whose testicles were removed to control prostate cancer. The researchers chose these men because the contraceptive vaccine suppresses testosterone levels, indicating that it may treat prostate cancer. Like animals used for 7 years of testing, the men did not experience any side effects of the vaccine. Yet, multiple injections of the vaccine induced sperm antibodies only in 3 of the men. The Council's Director of Contraceptive Development asks whether to reject a vaccine that has limited effectiveness or combine it with something else. A shortage of funds earmarked for contraceptive vaccine research is another obstacle. A contraceptive vaccine will not be on the market before the year 2000. PMID:12179185

  15. Sex differences in prevalence rates and predictors of cigarette smoking among in-school adolescents in Kilimanjaro, Tanzania.

    PubMed

    Siziya, S; Ntata, P R T; Rudatsikira, E; Makupe, C M; Umar, E; Muula, A S

    2007-09-01

    An analysis of the Global Youth Tobacco Survey for Kilimanjaro, Tanzania was carried out to assess sex differences in the prevalence rates and predictors of current cigarette smoking among in-school adolescents. A total of 2323 adolescents participated in the study of whom 53% were females and 47% males. The prevalence of current cigarette smoking was 3.0% and 1.4% among males and females, respectively. The common factors that were significantly positively associated with cigarette smoking between sexes were: having more pocket money, closest friend smoked cigarettes, seeing actors smoke on TV, videos or movies, and seeing advertisements for cigarettes at social gatherings. Seeing anti-smoking messages at social gatherings were negatively associated with smoking among both sexes. While having had something such as a t-shirt or pen with a cigarette brand logo on it was positively associated with cigarette smoking among males, it was negatively associated with cigarette smoking among females. Male adolescents older than 15 years, those in their 9th year of schooling, and those who had seen cigarette brand names on TV were more likely to smoke. Meanwhile, male respondents who were in their 8th year of schooling, had seen anti-smoking media messages, and advertisements for cigarettes in newspapers or magazines were less likely to smoke. Among female adolescents, those who had parents who smoked, and surprisingly those who perceived that cigarette smoking as harmful were more likely to smoke. Interestingly, seeing advertisement for cigarettes on billboards was negatively associated with smoking among female adolescents. Interventions aimed to reduce adolescent smoking need to be designed and implemented with due consideration of sex differences in these associated factors. PMID:18087898

  16. Antimicrobial resistance status and prevalence rates of extended spectrum beta-lactamase producers isolated from a mixed human population

    PubMed Central

    Afunwa, Ruth A.; Odimegwu, Damian C.; Iroha, Romanus I.; Esimone, Charles O.

    2011-01-01

    Owing to the increasing epidemiological and therapeutic challenges associated with infections due to ESBL producers, ESBL prevalence rate among some bacteria isolates from healthy and non-healthy human population in a metropolitan Nigerian setting was evaluated. A total of one hundred and forty-five (145) bacteria strains were isolated from a total of four hundred and sixty (460) samples collected from urine, wound, throat and anal swabs of 220 healthy volunteers in the community and from 240 patients in 2 secondary and 2 tertiary hospitals (altogether, 4) in Enugu metropolis. The presumptive confirmatory test used for ESBL detection was the Double Disc Synergy Test (DDST) method. Conjugation and plasmid curing studies were also done for resistance factor determination. Of the 145 isolates, 20 were ESBL producers with 35% of these ESBL producers being of community origin and 65% from hospitals. This translates to 4.8% and 9% incidences (comparably higher than established prevalence of 4.4% and 7.5 respectively) for community and hospital infections respectively. The ESBL isolates showed high resistance to tetracycline, gentamicin, pefloxacin, ceftriaxone, cefuroxime, ciprofloxacin and Augmentin® (Amoxicilin and clavulanic acid combination). Conjugation studies for Resistance plasmid transfer showed non-transference of resistance determinants between the ESBL transconjugants and recipient strains. Correspondingly, the plasmid curing studies revealed that the acridine orange could not effect a cure on the isolates as they still retained high resistance to the antibiotics after the treatment. This study confirms the growing incidences/pool of ESBL strains in Nigeria and call for widespread and continuous monitoring towards an effective management of the potential therapeutic hurdle posed by this trend. PMID:21619555

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

    PubMed

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

    2014-11-01

    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

  18. International standardization of mechanical contraceptives.

    PubMed

    Mellstam, S

    1983-06-01

    At least 12 countries have regulations for condoms, and because of the complicated regulations relating to condoms the International Organization for Standardization (ISO) was asked to create a committee for contraceptives. Its objective is to promote the development of standards throughout the world to help the international exchange of goods and services. Following discussions between the World Health Organization (WHO) and ISO it was decided in 1974 to establish a technical ISO committee that would deal with international standards for mechanical contraceptives, comprising condoms, diaphragms, and IUDs. It was also decided that spermicides and oral contraceptives (OCs) should be excluded from the ISO effort, but that they should fall within the responsibility of WHO. The committee, entitled ISO/TC 157 Mechanical Contraceptives, was represented by 35 member countries in 1982. The object of standardizing condoms is to obtain a satisfactory quality that can be accepted throughout the world. To achieve that purpose, acceptable test methods and associated limit requirements and values must be determined, along with rules for storage, packaging, and labeling. The most important factors in determining condom quality are the need to reach agreement on an acceptable number of holes in the condom and the ability to establish limit values for the mechanical properties of the condom. Specific requirements regarding dimensions, resistance to storage, packaging, labeling, and appropriate storage are also important. Up to 1982 the work of ISO for condoms resulted in 8 published international standards, of which 6 deal with test methods, 1 with packaging and labeling, and 1 with storage. Agreement has also been reached within the ISO committee on an additional 3 draft standards. Due to the comparatively small use of diaphragms, standardization efforts in this area do not have the highest priority. ISO/TC 157 has formulated 10 drafts which are being prepared for distribution to the ISO member countries for purposes of voting. 7 of these standards deal with test methods, 1 with sampling and requirements, 1 makes storage recommendations, and 1 refers to packaging and labeling. A working group for standardizing IUDs was established in 1976. It was agreed within ISO/TC 157 after almost 3 years to publish a Technical Report (TR 7439) for IUDs. The report deals with such things as the definition of IUDs, general requirements for type approval, batch inspection, storage recommendations, and packaging and labeling. The report shall constitute the basis for continued standardization efforts for IUDs. PMID:12279411

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

    SciTech Connect

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

    1991-08-01

    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.

  20. Changing contraceptive laws in New York State.

    PubMed

    1976-08-01

    In July 1975 a 3-judge federal court declared New York State's antic ontraceptive law unlawful under the U.S. Federal Constitution. The law prohibited sale of contraceptive to anyone under age 16, allowed sale of contraceptives in pharmacies only, and forbade display of contraceptive products on store counters and media advertisement. Population Services International initiated the case. The New York legislature declined to rewrite the law to make it constitutional; therefore, there is now no legal restriction on the sale, advertising, promotion, or display of contraceptives in New York State. New York has appealed to the Supreme Court, and if there is an affirmation of the lower court decision, there will be sweeping implications for laws in 25 other states with restrictive legislation. Contraceptives are becoming increasingly available throughout New York State, and the legal changes are highly cost-effective for family planning groups. PMID:12258266

  1. Maternal use of oral contraceptives and risk of birth defects in Denmark: prospective, nationwide cohort study

    PubMed Central

    Mølgaard-Nielsen, Ditte; Svanström, Henrik; Wohlfahrt, Jan; Pasternak, Björn; Melbye, Mads

    2016-01-01

    Study question Is oral contraceptive use around the time of pregnancy onset associated with an increased risk of major birth defects? Methods In a prospective observational cohort study, data on oral contraceptive use and major birth defects were collected among 880 694 live births from Danish registries between 1997 and 2011. We conservatively assumed that oral contraceptive exposure lasted up to the most recently filled prescription. The main outcome measure was the number of major birth defects throughout one year follow-up (defined according to the European Surveillance of Congenital Anomalies classification). Logistic regression estimated prevalence odds ratios of any major birth defect as well as categories of birth defect subgroups. Study answer and limitations Prevalence of major birth defects (per 1000 births) was consistent across each oral contraceptive exposure group (25.1, never users; 25.0, use >3 months before pregnancy onset (reference group); 24.9, use 0-3 months before pregnancy onset (that is, recent use); 24.8, use after pregnancy onset). No increase in prevalence of major birth defects was seen with oral contraceptive exposure among women with recent use before pregnancy (prevalence odds ratio 0.98 (95% confidence interval 0.93 to 1.03)) or use after pregnancy onset (0.95 (0.84 to 1.08)), compared with the reference group. There was also no increase in prevalence of any birth defect subgroup (for example, limb defects). It is unknown whether women took oral contraceptives up to the date of their most recently filled prescription. Also, the rarity of birth defects made disaggregation of the results difficult. Residual confounding was possible, and the analysis lacked information on folate, one of the proposed mechanisms. What this study adds Oral contraceptive exposure just before or during pregnancy does not appear to be associated with an increased risk of major birth defects. Funding, competing interests, data sharing BMC was funded by the Harvard T H Chan School of Public Health’s Maternal Health Task Force and Department of Epidemiology Rose Traveling Fellowship; training grant T32HD060454 in reproductive, perinatal, and paediatric epidemiology and award F32HD084000 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development; and grant T32CA09001 from the National Cancer Institute. The authors have no competing interests or additional data to share. PMID:26738512

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

    PubMed Central

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

    2014-01-01

    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

  3. [Update on the use of oral contraceptives in the treatment of endometriosis].

    PubMed

    Triano-Sánchez, R; de Prado-Prieto, L

    2012-03-01

    Endometriosis has a prevalence of about 10% and benefits from hormonal contraceptive treatment. It is a chronic and recurrent illness that occurs in fertile women, and is characterised by ectopic endometrial tissue. Clinical manifestations are: infertility, pain and pelvic mass. The goals of the treatment are: relief of symptoms, prevention of progression of disease and the stimulation of fertility. Current treatment options are: Expectant management, analgesia, hormonal therapy, surgery and combined therapies. The use of combined contraceptives is associated with a reduced risk of developing endometriosis, they are also a good choice to prevent pregnancy, and for women with minimal or mild symptoms. Progestins are used for symptomatic endometriosis and as an adjuvant to surgery. The combined contraceptives and the progestins must be considered as a first line treatment. PMID:24895705

  4. An “Imperfect” Contraceptive Society: Fertility and Contraception in Italy

    PubMed Central

    Gribaldo, Alessandra; Judd, Maya D.; Kertzer, David I.

    2013-01-01

    Italy represents an unexpected and in some ways paradoxical outcome in terms of fertility control: a drop to one of the lowest birth rates in the world has been accompanied by the preponderant use of “traditional” methods despite the availability of “modern” contraception. Using data from 349 interviews conducted in 2005–2006 in four Italian cities, we argue that Italian women achieve “unplanned” AND desired conceptions through the use of withdrawal and natural methods. While data from other countries reveal similar notions of ambivalence surrounding pregnancy intentions and contraceptive use, Italy stands out for the surprising correlation between highly “managing” the conditions under which children are born and the socially commended approach of “letting births happen”. Such results suggest the need to rethink theoretical understandings of low fertility. Through the use of non-technological methods individuals manipulate culturally produced norms and beliefs about the appropriate moment to have a child; simultaneously, their actions are embedded in larger cultural, economic, and political processes. PMID:25045191

  5. Survey of opinions of mothers and teenage daughters on sexual behavior and contraception: descriptive study and literature review

    PubMed Central

    Palatnik, Anna; Seidman, Daniel S

    2012-01-01

    Background The aim of this survey was to examine sexual behavior, use of contraception, and communication regarding these issues between mothers and their teenage daughters. Methods This descriptive cohort study included 314 pairs of women aged 15–24 years and their mothers, from an urban area in Israel. The participants completed questionnaires about sexual history and contraceptive usage. The main outcome measures were differences in sexual behavior and use of contraception between the two generations. Results Seventy-six percent of the daughters used effective contraception during their first intercourse versus only 29% of their mothers. Of the daughters, 48% had consulted their mothers regarding sexual relationships and use of contraception before beginning to use contraception. The vast majority of the mothers (96%) acknowledged that it was important to discuss these issues with their teenage daughters, but only 66% of them had actually spoken to their daughters about the subject. Daughters who did not discuss contraceptive matters with their mothers tended to be younger at the time of first sexual intercourse, to use the pill less often and the condom more often, and to have a slightly higher rate of elective abortions. Conclusion This study contributes to our understanding of mother and daughter attitudes regarding contraception, intergenerational differences in this regard, and the importance of mother-daughter communication. PMID:22792009

  6. Burden of unintended pregnancy in the United States: Potential savings with increased use of long-acting reversible contraception

    PubMed Central

    Trussell, James; Henry, Nathaniel; Hassan, Fareen; Prezioso, Alexander; Law, Amy; Filonenko, Anna

    2013-01-01

    Background This study evaluated the total costs of unintended pregnancy (UP) in the United States from a third -party health care payer perspective and explored the potential role for long-acting reversible contraception (LARC) in reducing UP and resulting health care expenditure. Study Design An economic model was constructed to estimate direct costs of UP as well as the proportion of UP costs that could be attributed to imperfect contraceptive adherence. The model considered all US women requiring reversible contraception: the pattern of contraceptive use and rates of UP were derived from published sources. The costs of UP in the United States and the proportion of total cost that might be avoided by improved adherence through increased use of LARC were estimated. Results Annual medical costs of UP in the United States were estimated to be $4.5 billion, and 53% of these were attributed to imperfect contraceptive adherence. If 10% of women aged 2029 years switched from oral contraception to LARC, total costs would be reduced by $288 million per year. Conclusions Imperfect contraceptive adherence leads to substantial unintended pregnancy and high, avoidable costs. Improved uptake of LARC may generate health care cost savings by reducing contraceptive non-adherence. PMID:22959904

  7. Timing of contraceptive initiation and association with future sexual and reproductive outcomes

    PubMed Central

    True, Kimberley; Bajos, Nathalie; Bohet, Aline; Moreau, Caroline

    2014-01-01

    STUDY QUESTION Who initiates contraception before, at the time or after first sexual intercourse and how does timing of initiation affect future sexual and reproductive health (SRH) outcomes? SUMMARY ANSWER Earlier initiation was associated with current utilization of more effective contraception, but had no impact on future unintended pregnancy, abortion or sexually transmitted infection rates, while later initiation was linked to higher rates of unintended pregnancies and abortions. WHAT IS KNOWN ALREADY Contraceptive behaviour at first intercourse is associated with later SRH outcomes. STUDY DESIGN, SIZE, DURATION Data were drawn from the FECOND study, the last national SRH study in France, conducted in 2010–2011 by phone among 8645 individuals aged 15–49 years. PARTICIPANTS/MATERIALS, SETTING, METHODS Analysis was performed among 1552 women under the age of 30 years who were sexually experienced and had used contraception at some point. We used logistic regression models to identify factors associated with timing of contraception initiation relative to first intercourse (earlier, at the time and later) and its predictive value on future sexual and reproductive outcomes. MAIN RESULTS AND THE ROLE OF CHANCE Timing of contraceptive initiation across all three categories (earlier, at the time and later initiators) was dependent on women's age at the time of the survey, country of birth, education level, ease of discussing sex with mother and age of first sex. Using at the time initiators as a reference, later initiators had higher odds of unintended pregnancy [odds ratio (OR) = 1.8] and abortion (OR = 1.9), while earlier initiators were more likely to be using more effective contraception at the time of the survey (OR = 1.8). LIMITATIONS, REASONS FOR CAUTION The exclusion of sexually inexperienced women, a quarter of which had ever used the pill, may have reduced the scope of our analysis on the relevance of contraceptive initiation for non-contraceptive benefits. WIDER IMPLICATIONS OF THE FINDINGS The promotion of early initiation of contraception may contribute to long-term use of more effective methods of contraception. STUDY FUNDING/COMPETING INTEREST(S) The FECOND study was supported by a grant from the French Ministry of Health, a grant from the French National Agency of Research (#ANR-08-BLAN-0286-01; PIs N. Bajos, C Moreau) and funding from the National Institute of Health and Medical Research (INSERM) and the National Institute for Demographic Research (INED). None of the authors have a conflict of interest. PMID:24916436

  8. Australian scientists develop male contraceptive.

    PubMed

    1974-05-20

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

  9. [Post-abortion contraception: effects of contraception services and reproductive intention].

    PubMed

    Borges, Ana Luiza Vilela

    2016-01-01

    Contraceptive counseling and the supply of contraceptive methods are part of post-abortion care and positively influence the subsequent use of contraceptive methods. Studies showing such evidence have been conducted predominantly in countries with no legal restrictions on abortion and with adequate care for women that terminate a pregnancy. However, little is known about contraceptive practices in contexts where abortion is illegal, as in Brazil, in which post-abortion contraceptive care is inadequate. The objective of this study was to analyze the effect of contraceptive care on male condom use and oral and injectable contraceptives in the six months post-abortion, considering reproductive intention. The results showed that contraceptive care only has a positive effect on the use of oral contraceptives in the first six months post-abortion, as long as the woman had a medical consultation in the same month in which she received information on contraception. One or the other intervention alone had no significant impact. PMID:26910252

  10. Hormonal contraceptives and asthma in women of reproductive age: analysis of data from serial national Scottish Health Surveys

    PubMed Central

    Nwaru, Bright I

    2015-01-01

    Objectives Sex steroid hormones may explain known gender-related variations in asthma prevalence and clinical manifestation. We investigated the relationship between use of hormonal contraceptives and asthma in women, and assessed evidence of biological interaction between use of hormonal contraceptives and body mass index in this relationship. Design Population-based analysis using data from serial (i.e. 2003, 2008 and 2010) Scottish Health Surveys. Setting Random samples of the Scottish general population. Participants A total of 3257 non-pregnant, 16–45-year-old women. Exposure Current use of hormonal contraceptives. Main outcome measures Self-reported current physician-diagnosed asthma, current wheezing symptoms, wheezing attacks and treatment for asthma or wheeze. Results Women comprising 30.9% (95% confidence interval 29.3–32.5) were currently using any hormonal contraceptive and current physician-diagnosed asthma was present in 6.5% (95% confidence interval 5.7–7.4). Use of any hormonal contraceptive was associated with reduced risk of current physician-diagnosed asthma (odds ratio 0.68; 95% confidence interval 0.47–0.98) and receiving ≥3 asthma care episodes (odds ratio 0.45; 95% confidence interval 0.25–0.82), but the evidence was equivocal for wheezing attacks. Use of hormonal contraceptives among overweight or obese women was non-statistically significantly associated with asthma, but there was 42–135% increased risk in overweight and obese non-contraceptive using women. Conclusions Use of hormonal contraceptives may reduce asthma exacerbations and number of care episodes. Overweight and obese non-contraceptive-using women may be at increased risk of asthma. Prospective studies are now needed to confirm these findings. Both oestrogen and progesterone may stimulate smooth airway muscle function and inhibit the activities of TH2 responses. Future studies should investigate these underlying mechanisms. PMID:26152676

  11. Seizure facilitating activity of the oral contraceptive ethinyl estradiol.

    PubMed

    Younus, Iyan; Reddy, Doodipala Samba

    2016-03-01

    Contraceptive management is critical in women with epilepsy. Although oral contraceptives (OCs) are widely used by many women with epilepsy, little is known about their impact on epileptic seizures and epileptogenesis. Ethinyl estradiol (EE) is the primary component of OC pills. In this study, we investigated the pharmacological effect of EE on epileptogenesis and kindled seizures in female mice using the hippocampus kindling model. Animals were stimulated daily with or without EE until generalized stage 5 seizures were elicited. EE treatment significantly accelerated the rate of epileptogenesis. In acute studies, EE caused a significant decrease in the afterdischarge threshold and increased the incidence and severity of seizures in fully-kindled mice. In chronic studies, EE treatment caused a greater susceptibility to kindled seizures. Collectively, these results are consistent with moderate proconvulsant-like activity of EE. Such excitatory effects may affect seizure risk in women with epilepsy taking OC pills. PMID:26874323

  12. The Male Role in Contraception: Implications for Health Education.

    ERIC Educational Resources Information Center

    Chng, Chwee Lye

    1983-01-01

    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)

  13. Males and Morals: Teenage Contraceptive Behavior Amid the Double Standard

    ERIC Educational Resources Information Center

    Scales, Peter

    1977-01-01

    This paper reviews literature on teenage contraceptive behavior and teenage contraceptive decision making. The paper describes the persistence of a sexual double standard in terms of moral motivation to use contraception and in terms of the relative lack of communication about contraception among young partners. (Author)

  14. The Contraceptive Needs for STD Protection among Women in Jail

    ERIC Educational Resources Information Center

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

    2010-01-01

    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

  15. The Contraceptive Needs for STD Protection among Women in Jail

    ERIC Educational Resources Information Center

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

    2010-01-01

    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…

  16. Name that Contraceptive! A Game for the Human Sexuality Classroom

    ERIC Educational Resources Information Center

    Rosenthal, Martha S.

    2010-01-01

    There are many contraceptive choices available to people today. Learning about them can be dry, but the game "Name that Contraceptive!" can be a fun and interactive way to review, remember, and retain the details about contraceptive options. Name that Contraceptive is a card game in which students "bid" on the number of clues it will take them to…

  17. Prevalence and occurrence rate of Mycobacterium tuberculosis Haarlem family multi-drug resistant in the worldwide population: A systematic review and meta-analysis

    PubMed Central

    Ramazanzadeh, Rashid; Roshani, Daem; Shakib, Pegah; Rouhi, Samaneh

    2015-01-01

    Background: Transmission of Mycobacterium tuberculosis (M. tuberculosis) can occur in different ways. Furthermore, drug resistant in M. tuberculosis family is a major problem that creates obstacles in treatment and control of tuberculosis (TB) in the world. One of the most prevalent families of M. tuberculosis is Haarlem, and it is associated with drug resistant. Our objectives of this study were to determine the prevalence and occurrence rate of M. tuberculosis Haarlem family multi-drug resistant (MDR) in the worldwide using meta-analysis based on a systematic review that performed on published articles. Materials and Methods: Data sources of this study were 78 original articles (2002-2012) that were published in the literatures in several databases including PubMed, Science Direct, Google Scholar, Biological abstracts, ISI web of knowledge and IranMedex. The articles were systematically reviewed for prevalence and rate of MDR. Data were analyzed using meta-analysis and random effects models with the software package Meta R, Version 2.13 (P < 0.10). Results: Final analysis included 28601 persons in 78 articles. The highest and lowest occurrence rate of Haarlem family in M. tuberculosis was in Hungary in 2006 (66.20%) with negative MDR-TB and in China in 2010 (0.8%), respectively. From 2002 to 2012, the lowest rate of prevalence was in 2010, and the highest prevalence rate was in 2012. Also 1.076% were positive for MDR and 9.22% were negative (confidence interval: 95%).0020. Conclusion: Many articles and studies are performed in this field globally, and we only chose some of them. Further studies are needed to be done in this field. Our study showed that M. tuberculosis Haarlem family is prevalent in European countries. According to the presence of MDR that was seen in our results, effective control programs are needed to control the spread of drug-resistant strains, especially Haarlem family. PMID:25767526

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

    PubMed Central

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

    1989-01-01

    There has been a recent increase in notifications of genital herpes but it is not known whether this has been reflected in the pregnant population. We have therefore carried out a study to determine the prevalence of herpes simplex antibodies in pregnant women and to estimate the incidence of primary infection. Sera were collected from 3533 women at antenatal clinics and tested for total antibodies to herpes simples virus (HSV), and if positive, for specific antibodies to HSV-2. Estimates of HSV-1 seroprevalence were derived from the HSV-2 seronegative population. HSV-1 seroprevalence was nearly 100% in black women born in Africa or the Caribbean and 60-80% in white, Asian and UK born black women. It was lower in women in non-manual employment. HSV-2 seroprevalence was related to age, rising from 0 at age 16 to 40% at age 35 in black women, and to about 10% in Asian and white women. The estimated incidence of primary HSV-2 infection during pregnancy, per 1000 pregnancies, was about 2.4 in Asian women, 5 in white women, and 20 in black women. Estimates of the incidence of neonatal infection were derived from these figures and compared to the nationally reported rates. PMID:2556492

  19. Reported Diabetes Mellitus Prevalence Rates in the Colombia Healthcare System from 2009 to 2012: Analysis by Regions Using Data of the Official Information Sources

    PubMed Central

    Barengo, Noël C.; Tamayo, Diana Carolina

    2015-01-01

    The objective of this study was to describe the reported diabetes mellitus (DM) prevalence rates of the 20–79-year-old population in Colombia from 2009 to 2012 reported by the healthcare system. Information on number of patients treated for DM was obtained by the Integral Information System of Social Protection (SISPRO), the registry of the Ministry of Health and Social Protection, and the High Cost Account (CAC), an organization to trace high expenditure diseases. From both sources age-standardized reported DM prevalence rates per 100.000 inhabitants from 2009 to 2012 were calculated. Whereas the reported DM prevalence rates of SISPRO revealed an increase from 964/100.000 inhabitants (2009) to 1398/100.000 inhabitants in 2012 (mean annual increase 141/100.000; p value: 0.001), the respective rates in the CAC register were 1082/100.000 (2009) and 1593/100.000 in 2012 (mean annual increase 165/100.000; p value: 0.026). The number of provinces reporting not less than 19% of the highest national reported DM prevalence rates (1593/100.000) increased from two in 2009 to ten in 2012. Apparently, the registries and the information retrieving system have been improved during 2009 and 2012, resulting in a greater capacity to identify and report DM cases by the healthcare system. PMID:26494999

  20. Reported Diabetes Mellitus Prevalence Rates in the Colombia Healthcare System from 2009 to 2012: Analysis by Regions Using Data of the Official Information Sources.

    PubMed

    Barengo, Noël C; Tamayo, Diana Carolina

    2015-01-01

    The objective of this study was to describe the reported diabetes mellitus (DM) prevalence rates of the 20-79-year-old population in Colombia from 2009 to 2012 reported by the healthcare system. Information on number of patients treated for DM was obtained by the Integral Information System of Social Protection (SISPRO), the registry of the Ministry of Health and Social Protection, and the High Cost Account (CAC), an organization to trace high expenditure diseases. From both sources age-standardized reported DM prevalence rates per 100.000 inhabitants from 2009 to 2012 were calculated. Whereas the reported DM prevalence rates of SISPRO revealed an increase from 964/100.000 inhabitants (2009) to 1398/100.000 inhabitants in 2012 (mean annual increase 141/100.000; p value: 0.001), the respective rates in the CAC register were 1082/100.000 (2009) and 1593/100.000 in 2012 (mean annual increase 165/100.000; p value: 0.026). The number of provinces reporting not less than 19% of the highest national reported DM prevalence rates (1593/100.000) increased from two in 2009 to ten in 2012. Apparently, the registries and the information retrieving system have been improved during 2009 and 2012, resulting in a greater capacity to identify and report DM cases by the healthcare system. PMID:26494999

  1. The efficacy of intrauterine devices for emergency contraception: a systematic review of 35 years of experience

    PubMed Central

    Cleland, Kelly; Zhu, Haoping; Goldstuck, Norman; Cheng, Linan; Trussell, James

    2012-01-01

    BACKGROUND Intrauterine devices (IUDs) have been studied for use for emergency contraception for at least 35 years. IUDs are safe and highly effective for emergency contraception and regular contraception, and are extremely cost-effective as an ongoing method. The objective of this study was to evaluate the existing data to estimate the efficacy of IUDs for emergency contraception. METHODS The reference list for this study was generated from hand searching the reference lists of relevant articles and our own article archives, and electronic searches of several databases: Medline, Global Health, Clinicaltrials.gov, Popline, Wanfang Data (Chinese) and Weipu Data (Chinese). We included studies published in English or Chinese, with a defined population of women who presented for emergency contraception and were provided with an IUD, and in which the number of pregnancies was ascertained and loss to follow-up was clearly defined. Data from each article were abstracted independently by two reviewers. RESULTS The 42 studies (of 274 retrieved) that met our inclusion criteria were conducted in six countries between 1979 and 2011 and included eight different types of IUD and 7034 women. The maximum timeframe from intercourse to insertion of the IUD ranged from 2 days to 10 or more days; the majority of insertions (74% of studies) occurred within 5 days of intercourse. The pregnancy rate (excluding one outlier study) was 0.09%. CONCLUSIONS IUDs are a highly effective method of contraception after unprotected intercourse. Because they are safe for the majority of women, highly effective and cost-effective when left in place as ongoing contraception, whenever clinically feasible IUDs should be included in the range of emergency contraception options offered to patients presenting after unprotected intercourse. This review is limited by the fact that the original studies did not provide sufficient data on the delay between intercourse and insertion of the IUD, parity, cycle day of intercourse or IUD type to allow analysis by any of these variables. PMID:22570193

  2. Progestin-only contraception: injectables and implants.

    PubMed

    Jacobstein, Roy; Polis, Chelsea B

    2014-08-01

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

  3. Controversies in contraception for women with epilepsy

    PubMed Central

    Thomas, Sanjeev V.

    2015-01-01

    Contraception is an important choice that offers autonomy to women with regard to prevention of unintended pregnancies. There is wide variation in the contraceptive practices between continents, countries, and societies. The medical eligibility for contraception for sexually active women with epilepsy (WWE) is determined by the type of anti-epileptic drugs (AEDs) that they use. Enzyme inducing AEDs such as phenobarbitone, phenytoin, carbamazepine, and oxcarbazepine increase the metabolism of orally administered estrogen (and progesterone to a lesser extent). Estrogen can increase the metabolism of certain AEDs, such as lamotrigine, leading to cyclical variation in its blood level with resultant adverse effect profile or seizure dyscontrol. AEDs and sex hormones can increase the risk of osteoporosis and fracture in WWE. The potential interactions between AEDs and hormonal contraception need to be discussed with all women in reproductive age-group. The alternate options of oral contraception such as intrauterine copper device, intrauterine levonorgestrel release system, and supplementary protection with barriers need to be presented to them. World Health Organization has recommended to avoid combination contraceptive pills containing estrogen and progesteron in women who desire contraception and in breastfeeding mothers. Care providers need to consider the option of non-enzyme-inducing AEDs while initiating long-term treatment in adolescent and young WWE. PMID:26425002

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

    PubMed

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

    1993-06-01

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

  5. A review of the use of progestogen-only minipills for contraception during lactation.

    PubMed

    Fraser, I S

    1991-01-01

    Progestogen-only minipills and other systems for releasing low doses of progestogens alone are widely used for contraception in breast-feeding women around the world. There is good evidence to confirm their acceptability and their lack of effect on milk production, neonatal growth and early development. In contrast, combined oral contraceptives frequently decrease milk production, and may produce minor changes in milk composition. However, even combined oral contraceptives do not appear to produce adverse effects on neonatal well-being and development, although minor reductions in initial growth rate may sometimes occur. Progestogen-only methods may also produce subtle changes in milk composition, although less than combined oral contraceptives. Steroids are transferred from plasma into milk in small quantities, but the amounts are usually very low or insufficient to allow detection in the infants using present-day assays. There has been theoretical concern that these tiny amounts of steroids might affect neonatal reproductive development, but this appears to be unwarranted. Progestogen-only methods are being widely used for post-partum contraception, and they appear to have particular advantages in this situation. They also have few disadvantages; a theoretical concern about a possible effect on later reproductive or sexual development has no evidence to support it. The present licensing situation in Australia, which lists lactation as a relative contraindication to progestogen-only contraceptive use, causes real concern to potential users and appears to lead to frequent errors in compliance. PMID:1947224

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

    PubMed

    Yee, Lynn M; Simon, Melissa A

    2014-04-01

    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

  7. Youth with Disabilities in the Corrections System: Prevalence Rates and Identification Issues. Monograph Series on Education, Disability and Juvenile Justice.

    ERIC Educational Resources Information Center

    Rutherford, Robert B., Jr.; Bullis, Michael; Anderson, Cindy Wheeler; Griller-Clark, Heather M.

    This monograph, one of a series on youth with disabilities and the juvenile justice system, reviews current data on disabilities requiring special education and related supports. Statistics on the prevalence of juvenile crime are followed by statistics on the prevalence of special education disabilities in the system, specifically specific…

  8. State-of-the-art of non-hormonal methods of contraception: IV. Natural family planning.

    PubMed

    Freundl, Günter; Sivin, Irving; Batár, István

    2010-04-01

    Despite the popularity of 'modern' contraceptives, natural family planning (NFP), including fertility awareness-based (FAB) methods and withdrawal, are practised in most countries. Worldwide FAB methods and withdrawal are used, respectively, by about 3.6% and 2.9% of all couples of reproductive age. This article describes the underpinnings of the different NFP methods, their rationales, histories, rules for use, efficacy and in broad categories their prevalence. Pregnancy rates of FAB methods with perfect use have ranged between 0.3 and 5.0 per 100 users per year, but typical use rates rises into the teens or higher. Withdrawal requires the male partner to be aware of his impending climax and to pull out of the vagina before ejaculation. Perfect use and typical pregnancy rates for withdrawal are estimated to be 4 and 27 per 100 per year, respectively. Many couples find NFP in accord with their own beliefs, satisfactory in its effectiveness and useful in planning a desired pregnancy. Many prize their self-control in practising NFP or withdrawal. In our research we used Medline, Popline and the Cochrane Library search engines in English, local institutional libraries, our own files in our native languages, the literature references contained therein, and source recommendations from colleagues. PMID:20141492

  9. [Postpartum and contraception after gestational diabetes].

    PubMed

    Kerlan, V

    2010-12-01

    Women who had gestational diabetes must have their glycemia closely checked after delivery to insure complete normalization. Few studies are published but breast feeding does not seem to modify the metabolic profile of the mother or the children. Contraception must take account associated risk factors. Very few studies are published and none notified a significant modification of the carbohydrate metabolism with hormonal contraception, either estroprogestative or progestative only. But associated obesity, hypertension or dyslipidemia need the prescription of a contraception with no vascular secondary effect. In these cases an intrauterine device represents a very good choice. PMID:21185480

  10. Choosing a combined oral contraceptive pill.

    PubMed

    Stewart, Mary; Black, Kirsten

    2015-02-01

    The combined oral contraceptive pill is an effective contraceptive method which can also offer other benefits. However, other contraceptive options should be discussed. If the pill is the chosen method, prescribe a pill with the lowest effective dose of oestrogen and progestogen. Pills containing levonorgestrel or norethisterone in combination with ethinyloestradiol 35 microgram or less are considered first-line. They are effective if taken correctly, have a relatively low risk of venous thromboembolism, and are listed on the Pharmaceutical Benefits Scheme. The pill is usually taken in a monthly cycle. Some women may prefer an extended pill regimen with fewer or no inactive pills. PMID:26648603

  11. Ulipristal - a new emergency contraceptive pill.

    PubMed

    2010-08-01

    Until recently, women in the UK who wanted emergency contraception had two options: an oral hormonal method (levonorgestrel), which is licensed for use up to 3 days after unprotected sexual intercourse; or a copper-bearing intrauterine device (IUD), which can be inserted up to 5 days after unprotected intercourse or up to 5 days after the earliest likely calculated ovulation. Now ulipristal acetate (ellaOne - HRA Pharma), a new oral hormonal emergency contraceptive, has been licensed in the European Union for use within 120 hours (5 days) of unprotected intercourse. Here we assess whether it is an advance for emergency contraception. PMID:20685898

  12. CONTRACEPTION TECHNOLOGY: PAST, PRESENT AND FUTURE

    PubMed Central

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

    2012-01-01

    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

  13. Choosing a combined oral contraceptive pill

    PubMed Central

    Stewart, Mary; Black, Kirsten

    2015-01-01

    Summary The combined oral contraceptive pill is an effective contraceptive method which can also offer other benefits. However, other contraceptive options should be discussed. If the pill is the chosen method, prescribe a pill with the lowest effective dose of oestrogen and progestogen. Pills containing levonorgestrel or norethisterone in combination with ethinyloestradiol 35 microgram or less are considered first-line. They are effective if taken correctly, have a relatively low risk of venous thromboembolism, and are listed on the Pharmaceutical Benefits Scheme. The pill is usually taken in a monthly cycle. Some women may prefer an extended pill regimen with fewer or no inactive pills. PMID:26648603

  14. Postpartum Care and Contraception in Obese Women.

    PubMed

    Maclean, Courtney C; Thompson, Ivana S

    2016-03-01

    Postpartum obese women have an increased risk of breastfeeding difficulties and depression. Retaining the pregnancy weight at 6 months postpartum predicts long-term obesity. Risks for weight retention include excessive gestational weight gain, ethnicity, socioeconomic status, diet, exercise, depression, and duration of breastfeeding. Exercise and reducing total caloric intake promote postpartum weight loss. Intrauterine devices and contraceptive implants are the most effective contraceptives for obese women. Contraceptive pills, patches, and vaginal rings are effective options; however, obese women should be made aware of a potential increased risk of venous thromboembolism. Vasectomy and hysteroscopic sterilization carry the least surgical risk for obese women. PMID:26694498

  15. Contraception update: implantable and injectable methods.

    PubMed

    Gold, M A

    1995-04-01

    There are currently more options available to pediatricians caring for sexually active adolescents who wish to prevent pregnancy. The two progestin-only methods, levonorgestrel subdermal implants and DMPA injections, minimize or entirely remove the obstacle of patient compliance from contraceptive efficacy. Adolescents considering a progestin-only method of contraception should be counseled explicitly about the likelihood of menstrual irregularity with use. Perhaps more importantly, adolescents should be reminded that hormonal methods of contraception do not provide protection from sexually transmitted disease. Thus, male condom use should not only be recommended, but also concrete discussion and instruction on appropriate use should be given. PMID:7596649

  16. Feminism and the Moral Imperative for Contraception.

    PubMed

    Espey, Eve

    2015-08-01

    This commentary is adapted from the Irvin M. Cushner Memorial Lecture, "Feminism and the Moral Imperative for Contraception," given at 2014 Annual Clinical Meeting of the American College of Obstetricians and Gynecologists in Chicago. It provides a brief and simplified historical review of the feminist movement, primarily in the United States, focusing on feminism's association with contraception. This commentary reflects the perspective and opinions of the author. Contraception is fundamental to a woman's ability to achieve equality and realize her full social, economic, and intellectual potential. PMID:26241431

  17. Political and economic factors influencing contraceptive uptake.

    PubMed

    Sai, F T

    1993-01-01

    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

  18. Male hormonal contraception: looking back and moving forward.

    PubMed

    Roth, M Y; Page, S T; Bremner, W J

    2016-01-01

    Despite numerous contraceptive options available to women, approximately half of all pregnancies in the United States and worldwide are unplanned. Women and men support the development of reversible male contraception strategies, but none have been brought to market. Herein we review the physiologic basis for male hormonal contraception, the history of male hormonal contraception development, currents agents in development as well as the potential risks and benefits of male hormonal contraception for men. PMID:26453296

  19. Contraceptive Counseling: Best Practices to Ensure Quality Communication and Enable Effective Contraceptive Use

    PubMed Central

    Dehlendorf, Christine; Krajewski, Colleen; Borrero, Sonya

    2014-01-01

    Improving the quality of contraceptive counseling is one strategy to prevent unintended pregnancy. We identify aspects of relational and task-oriented communication in family planning care that can assist providers in meeting their patients’ needs. Approaches to optimizing women's experiences of contraceptive counseling include working to develop a close, trusting relationship with patients and using a shared decision-making approach that focuses on eliciting and responding to patient preferences. Providing counseling about side effects and using strategies to promote contraceptive continuation and adherence can also help optimize women's use of contraception. PMID:25264697

  20. Adolescent knowledge and use of injectable contraceptives in developing countries.

    PubMed

    Singh, S

    1995-05-01

    A review of the findings of Demographic and Health Surveys carried out in 25 developing countries (10 in sub-Saharan Africa, 3 in North Africa, 3 in Asia, and 9 in Latin America and the Caribbean) in 1986-90 indicates a high degree of awareness of injectable contraception but very low levels of use. Over 80% of women 15-49 years of age in Indonesia, Sri Lanka, Thailand, Botswana, Colombia, and Mexico knew of the injectable contraceptive Depo-Provera; in the other countries, awareness was in the 40-70% range. In countries for which separate data were available for women 15-19 years of age, knowledge of injectable contraceptives tended to be 10-20% less than that for all women. In 13 of the 25 countries, knowledge of injectables was 20-30% less than that of the pill; however, injectable contraception was more recognized than the condom in 17 countries. There were only five countries--Indonesia, Sri Lanka, Thailand, Colombia, and Mexico--in which 10% or more of married women have used Depo-Provera. Among married adolescents, the highest rate of Depo-Provera use (7%) was found in Indonesia and Thailand; in other countries for which data on adolescents were available, use levels were in the 1-2% range. These low use levels are assumed to reflect both women's health concerns and the nonavailability of supplies from international donor agencies. However, recent approval by the US of Depo-Provera use is expected to increase its availability in developing countries. PMID:7662691

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

    PubMed Central

    Viegi, G; Paoletti, P; Carrozzi, L; Vellutini, M; Diviggiano, E; Di Pede, C; Pistelli, G; Giutini, G; Lebowitz, M D

    1991-01-01

    We surveyed two general population samples aged 8 to 64 living in the unpolluted, rural area of the Po Delta (northern Italy) (n = 3289) and in the urban area of Pisa (central Italy) (n = 2917). 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. In particular, rhinitis and wheezing symptoms were higher in all the three urban zones; chronic cough and phlegm were higher in the zone with the automobile exhaust and the additional industrial exposure. 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. For example, those living in the urban-industrial zone had an odds ratio of 4.0 (4.3-3.7) for rhinitis and 2.8 (3.0-2.6) for wheeze with respect to those living in the Po Delta.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1954948

  2. Postcoital Contraception: Student Choices and Effectiveness.

    ERIC Educational Resources Information Center

    Schilling, Lee H.

    1984-01-01

    Information was gathered from college students to observe choice of postcoital contraception (PCC) and the effectiveness of the choice. Results indicate that PCC is an effective second chance to prevent unintended pregnancy. Research methodology is presented. (Author/DF)

  3. Emergency contraception - a human rights issue.

    PubMed

    Croxatto, Horacio B; Fernández, Soledad Díaz

    2006-06-01

    Emergency contraception is the only resource that women can use to avoid becoming pregnant after having sexual intercourse without contraceptive protection. It could be a powerful means to prevent unwanted pregnancies and their devastating consequences for women's health, social wellbeing and life project, and for the unwanted child, if all people had ample access to good quality information, education and services for sexual and reproductive health. In spite of the preventive medicine value of emergency contraception, conservative sectors oppose its availability, appealing to moral values that are not universally shared in pluralistic societies. Excluding the only contraceptive that can be used after intercourse because some consider the mechanism of action to be unacceptable would mean restricting the right of choice of others, and imposing one particular belief or set of values on all members of the community, thus violating the freedom of conscience. Authorities have a moral obligation to protect human rights. PMID:16480928

  4. Mood and sexual side effects of hormonal contraception

    PubMed Central

    Wiebe, Ellen; Kaczorowski, Janusz; MacKay, Jacqueline

    2012-01-01

    Abstract Objective To explore physicians’ knowledge, attitudes, and practices related to sexual and mood side effects of hormonal contraceptives, and to compare residents with practising doctors. Design A mixed-method study with faxed or e-mailed surveys and semistructured telephone interviews. Setting British Columbia. Participants A random sample of family doctors, all gynecologists, and all residents in family medicine and gynecology in the College of Physicians and Surgeons of British Columbia registry. A subsample was interviewed. Main outcome measures Estimates of rates of mood and sexual side effects of contraceptives in the practice population and how the physicians informed and advised patients about these side effects. Results There were 79 residents and 76 practising doctors who completed the questionnaires (response rates of 42.0% and 54.7% of eligible residents and physicians, respectively). The reference sources most physicians reported using gave the rates of sexual and mood side effects of hormonal contraceptives as less than 1%, and yet only 1 (0.6%) respondent estimated similar rates for mood side effects, and 12 (7.8%) for sexual effects among their patients. The most common answers were rates of 5% to 10%, with residents reporting similar rates to practising doctors. Practising doctors were more likely to ask about sexual and mood side effects than residents were (81.1% vs 24.1% and 86.3% vs 40.5%, respectively; P < .001). Practising doctors were also more likely to recommend switching to barrier methods (37.3% vs 16.5%; P = .003) or intrauterine devices (54.7% vs 38.0%; P = .038) than residents were and more likely to give more responses to the question about how they managed sexual and mood side effects (mean of 1.7 vs 1.1 responses, P = .001). In 14 of the 15 interviews, practising doctors discussed how they had learned about side effects mainly from their patients and how this had changed their practices. Conclusion Physicians’ perceived rates of mood and sexual side effects from hormonal contraception in the general population were higher than the rate of less than 1% quoted in the product monographs. Practising doctors reported that they learned about the type, frequency, and severity of side effects from their patients. PMID:23152475

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

    PubMed Central

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

    2013-01-01

    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

  6. Biology of male fertility control: an overview of various male contraceptive approaches.

    PubMed

    Tulsiani, D R; Abou-Haila, A

    2015-04-01

    The population of our planet continues to grow at an alarming rate. If the growth continues at the present rate, the estimated current world population of about seven billion is expected to double in the next forty years. Accumulated data from surveys by the United Nations Population Control Division suggest that a majority of today's young men in many countries are willing to have fewer children than their parents did. However, the contraceptive options available to them have not changed in several decades. In spite of the general agreement that men, like women, must take full responsibility of their fertility, the availability of safe, reversible and affordable contraceptives for men have lagged behind because of the complexity of the science of the male reproductive system. Thus, the contraceptive needs of millions of men/couples go unmet every single day and results in millions of unwanted pregnancies. In this article, we intend to discuss new hormonal and non-hormonal contraceptive approaches that are at various stages of research and development and may someday provide new contraceptives for men. In addition, we intend to discuss many details of three safe, effective, affordable and reversible vas-based approaches that are inching closer to being approved for use by millions of men in multiple countries. Finally, our intention is to discuss the male contraceptive pill that will soon be available to men only in Indonesia. The availability of these male contraceptives will allow both men and women to take full control of their fertility and participate in slowing down the growth of world population. PMID:25516280

  7. Postpartum Contraception in Adolescents: Data From a Single Tertiary Clinic in Southeast of Turkey

    PubMed Central

    Kaplanoglu, Mustafa; Kaplanoglu, Dilek; Usman, Mustafa Gokhan

    2015-01-01

    Aim: We aimed to evaluate the postpartum contraception preferences of adolescent women in this study. Material and Method: This descriptive study was prepared after a retrospective analysis of file records of primigravida women who had given birth at the Adiyaman University School of Medicine Training and Research Hospital Department of Obstetric and Gynecology between January 2010 and June 2012. More than 12 months had passed after birth. The adolescents who were included in the study and the control group women were called by phone and invited to our clinic. A total of 506 adolescents and 1,046 control group women came to the clinic and were evaluated. The control group was formed of women between the age of 20-35 years who gave given birth in our clinic during the same period and were randomly selected. Postpartum obstetric history, contraception methods and data of these patients were recorded. Results: The mean age was 18.3±0.4 years and 28.2±4.9 years in the adolescent group and control group respectively. No contraception other than lactation amenorrhea was used by 256 women of the adolescent group (50.6%) and 345 women of the control group (33%). The most commonly used contraceptive method in both groups other than lactation amenorrhea was condoms (160 women (64%) and 230 women (32.8%) respectively). The annual contraceptive failure rate was 3.95% in the adolescent group and 1.72% in the control group. The highest failure rate was with lactation amenorrhea in both groups. Discussion: Adolescent women mostly use contraceptive methods with low reliability such as lactation amenorrhea and the calendar method in the postpartum period. Providing adequate contraceptive education is therefore important. On the other hand, starting such training starting in the early postnatal period will prevent recurring adolescent pregnancies with a short pregnancy interval. PMID:25716393

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

    PubMed Central

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

    2010-01-01

    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

  9. Provision of No-Cost, Long-Acting Contraception and Teenage Pregnancy

    PubMed Central

    Secura, Gina M.; Madden, Tessa; McNicholas, Colleen; Mullersman, Jennifer; Buckel, Christina M.; Zhao, Qiuhong; Peipert, Jeffrey F.

    2014-01-01

    Background The rate of teenage pregnancy in the United States is higher than in other developed nations. Teenage births result in substantial costs, including public assistance, health care costs, and income losses due to lower educational attainment and reduced earning potential. Methods The Contraceptive CHOICE Project was a large prospective cohort study designed to promote the use of long-acting, reversible contraceptive (LARC) methods to reduce unintended pregnancy in the St. Louis region. Participants were educated about reversible contraception, with an emphasis on the benefits of LARC methods, were provided with their choice of reversible contraception at no cost, and were followed for 2 to 3 years. We analyzed pregnancy, birth, and induced-abortion rates among teenage girls and women 15 to 19 years of age in this cohort and compared them with those observed nationally among U.S. teens in the same age group. Results Of the 1404 teenage girls and women enrolled in CHOICE, 72% chose an intrauterine device or implant (LARC methods); the remaining 28% chose another method. During the 2008–2013 period, the mean annual rates of pregnancy, birth, and abortion among CHOICE participants were 34.0, 19.4, and 9.7 per 1000 teens, respectively. In comparison, rates of pregnancy, birth, and abortion among sexually experienced U.S. teens in 2008 were 158.5, 94.0, and 41.5 per 1000, respectively. Conclusions Teenage girls and women who were provided contraception at no cost and educated about reversible contraception and the benefits of LARC methods had rates of pregnancy, birth, and abortion that were much lower than the national rates for sexually experienced teens. (Funded by the Susan Thompson Buffett Foundation and others.) PMID:25271604

  10. [Contraception as an aspect of family planning].

    PubMed

    Krzaklewski, S

    1979-01-01

    In Poland, contraception is not a politically and economically important as in the 3rd world. However, it is one of the major issues of preventive medicine and a very important aspect of family planning. This work deals with 2 modern contraceptive methods: hormonal pills and IUDs. It makes use of the Pearl failure index to evaluate the reliability of some domestic and imported contraceptives. The evaluation is based on observations and research by the Wroclaw Academy of Medicine. The Academy's research program is working to develop Polish contraceptives. An analysis of data collected over 12 years of research and development indicates that Poland could become independent of imported contraceptives. To achieve this goal, Poland should begin production of the Spiran W as a standard IUD which can be done once technological modifications and improvements are made. The Spide Cu should be made available as a universal IUD, with the functional parameters of the best 2nd-generation contraceptive devices. Flover Cu should replace the imported Copper T-200 as an IUD for women who have never given birth. Due to their advanced design, the Spider Cu and Flover Cu can also be exported to foreign countries. The Institute of Gynecology and Obstetrics affiliated with the Wroclaw Academy of Medicine can provide all of the documentation and technical service needed to organize the manufacture of these IUDs. PMID:12314828

  11. Making good use of nature's contraceptive.

    PubMed

    Short, R

    1992-10-01

    Some new recommendation on how to use breast feeding scientifically and a contraceptive method are suggested. We know that breastfeeding is the most important determinant of fertility in societies that do not have modern contraception. Breast milk has other benefits, such as immune protection against gastrointestinal diseases, reduced incidence of necrotizing enterocolitis, food allergies and diabetes, and possibly increasing the child's IQ. Breastfeeding can contribute to birth spacing, which can double the child's chance of survival relative to children born less than 2 years apart. Lactation can be up to 98% effective as a contraceptive during the 1st 6 months postpartum. It is suggested that the mother use her infant's development as a cue for beginning artificial contraception. When the child's teeth start erupting, it is time to start supplementing with other foods, and to start contraception. If she begins menstruating, the woman should, of course, begin contracepting at once. Another recommendation is to supplement the woman's diet with milk biscuits, throughout pregnancy and lactation rather than give cow's milk to infants in formula. Later on the biscuits could be given to babies for teething. PMID:12286079

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

    ERIC Educational Resources Information Center

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

    2010-01-01

    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.…

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

    PubMed Central

    2013-01-01

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

  14. [Survey of men provides reliable data on contraception in the Dominican Republic].

    PubMed

    1987-01-01

    Comparison of the results of 2 contraceptive prevalence surveys in the Dominican Republic, 1 of a sample of 4741 women in 1983 and the other of a sample of 4203 men in 1984, indicated that men and women have similar levels of knowledge and reported similar levels of use of contraceptives. Differences were noted in such areas as the acceptability of methods and the number of children each spouse desired. Both surveys were conducted by the National Council of Population and the Family. The women were aged 15-49 years and the men were 15-59. 2037 of the men were in union at the time of the survey and 2166 were single. The majority of respondents in both groups were under age 30. 44% of the men and 29% of the women under 30 were single. Dominican men are 5-10 years older than women on average when they enter stable unions. A comparison of age specific fertility rates of men and women showed that men have their highest level of fertility between 25-30 years and continue to reproduce beyond age 50, while women's fertility is highest between the ages of 20-29 and declines considerably thereafter. The total fertility rate was 4.2 for men aged 15-49 and 4.6 for men aged 15-59. It was 4.1 for women aged 15-49. Over 1/2 of men and 1/2 of women in union who had 2 or more children stated they wanted no more children, but at each parity men were more disposed to want another child. Women at all parities overestimated the number of children their partners wanted. The pill was the only contraceptive method that the majority of men and women who had ever been in union named spontaneously. When other methods were named, 94% of men and 97% of women ever in union knew about pills and female sterilization, 71% of men and 89% of women knew about IUDs, 71% of men and 80% of women knew about injectables, and 61% of men and 75% of women knew about vaginal methods. 92% of men and 88% of women knew about condoms. 46% of the women in union had been using a family planning method, including 27% who were sterilized and 9% who used pills. The responses of men when asked about their wives' contraceptive use were about the same. However, men reported higher use of male methods. 9% of men but only 1% of women reported using rhythm, 7% of men but 3% of women withdrawal, and 5% of men and 2% of women condoms. Among men not using a method, 61% reported they might use rhythm, condoms, withdrawal, or vasectomy in the future. 94% of men approved of at least 1 female method, but approval of specific methods varied widely. Over 80% of men in union approved of female sterilization and rhythm, but only 37% approved of pills and 41% of IUDs. The researchers concluded that men cooperate sufficiently to justify similar surveys in other Latin American countries, and that men can be reliable sources of information for programming and evaluation of family planning programs. PMID:12269052

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

    PubMed Central

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

    2013-01-01

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

  16. Receipt of Prescription Contraception by Commercially Insured Women With Chronic Medical Conditions

    PubMed Central

    DeNoble, Anna E.; Hall, Kelli S.; Xu, Xiao; Zochowski, Melissa K.; Piehl, Kenneth; Dalton, Vanessa K.

    2014-01-01

    Objective To assess differences in receipt of prescription contraception among women with and without chronic medical conditions. Methods This observational study used 3 years of administrative claims records for insured women aged 2145 years who were enrolled in a commercial insurance company in Michigan between 2004 and 2009. Women were considered to have a chronic medical condition if they had at least two claims for one of the following conditions, in order of prevalence in our study population: hypertension, asthma, hypothyroidism, diabetes, obesity, rheumatoid arthritis, inflammatory bowel disease, or systemic lupus erythematosus. Our primary outcome was receipt of prescription contraception, defined by a pharmacy claim or diagnostic or procedural code. We used multivariable logistic regression to estimate the association of chronic condition status with the odds of receiving prescription contraception within 3 years, adjusting for age, community-level socioeconomic status, total outpatient visits, and cervical cancer screening. Results Of 11,649 women studied, 16.0% (n=1,862) had at least one of the chronic conditions we considered. Of those with a chronic condition, 33.5% (n=623) received prescription contraception during the 3-year study period compared to 41.1% (n=4,018) of those without a chronic condition (p<0.001). After adjusting for covariates, women with a chronic condition remained less likely than women without a chronic condition to have received prescription contraception (adjusted odds ratio=0.85; 95% CI 0.76, 0.96; p=0.010). Conclusion Despite a greater risk for adverse outcomes with an unplanned pregnancy, women with these chronic conditions were less likely to receive prescription contraception. PMID:24807345

  17. [Oral contraception: failures and risks].

    PubMed

    Foussard-blanpin, O; Paillot-renaud, P; Bruneau-bigot, A

    1984-11-01

    This work describes oral contraceptives (OCs) in current use and examines their risks. OC pills are composed of synthetic estrogens, usually either ethinyl estradiol or mestranol, and progestins. Either estrogens or progestins can be used alone, but combinations permit smaller doses to be used. Combined pills are available in monophasic, biphasic, or triphasic formulations. Different modalities of administration are also available for progestin-only pills. The "morning after" pill containing high doses of steroids to be taken within 72 hours of unprotected intercourse can contain either estrogen or progestin alone or combined. The mechanisms of action of OCs vary according to the type of pill. Classic combined OCs inhibit ovulation, render the cervical mucus inhospitable to sperm, and cause endometrial atrophy which hinders nidation. Low-dose pills have various effects but in general depend on changes in the cervical mucus for their contraceptive effect. Pregnancy may result from forgetting pills or using them incorrectly, or in the case of low-dose pills may occur even if they are used correctly. Some drugs can lower the concentrations of the OC hormones at the level of the receptors by hindering their intestinal absorption or by increasing the metabolic power of the liver. Considerable individual variability limits the incidence of pill failure due to drug interactions, but OC use should be avoided if rifampicine or certain other drugs are used. Among undesirable effects of OCs on endocrine glands and reproductive function are the adaptation syndrome characterized by symptoms similar to those of early pregnancy and reversible in most but not all women; galactorrhea resulting from diminished levels of "prolactin inhibiting factor"; and virilizing effects such as alopecia, hirsutism, and acne usually occurring during use of high-dose formulations. Pills should be carefully adapted to the hormonal profile of the user to avoid these side effects. OCs very rarely entail longterm infertility. OCs in current use do not appear to be teratogenic but it is advisable to wait 2 months after termination of use before becoming pregnant. Lactation is a contraindication to OC use. Combined OCs frequently cause problems in glucose tolerance of variable significance. Low-dose progestins do not seem to affect lipid metabolism, but low and normal dose combined pills may provoke increases in the levels of cholesterol and triglycerides. OCs are implicated in vascular accidents of various kinds, but low-dose pills are better tolerated. Cardiovascular risks are increased by age, smoking, use of alcohol, and excess fat in the diet. Hepatobiliary complications may occur during pill use. The carcinogenic role of OCx remains controversial, although growth of preexisting breast cancers is accelerated with pill use. The multifactorial etiologies of cardiovascular ailments, atherosclerosis, and cancerous tumors make the role of OCs difficult to assess. OCs can interact with various drugs, heightening the undesirable effects of each. Research on hormonal methods of contraception is currently directed toward achieving a better tolerance and administration of both male and female methods. PMID:12280590

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

    PubMed Central

    Yee, Lynn M.; Simon, Melissa

    2010-01-01

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

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

    PubMed Central

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

    2013-01-01

    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

  20. Factors associated with contraceptive use and intention to use contraceptives among married women in Ethiopia.

    PubMed

    Tiruneh, Fentanesh Nibret; Chuang, Kun-Yang; Ntenda, Peter A M; Chuang, Ying-Chih

    2016-01-01

    Family planning has improved the well-being of families by preventing high-risk pregnancies and abortions and reducing unplanned pregnancies. However, the effectiveness of family planning efforts has not been consistent across countries. This study examined factors associated with contraceptive use among married women in Ethiopia. Data were from the 2011 Ethiopian Demographic and Health Survey. The sample comprised 10,204 married women (aged 15-49 years). Logistic regression models were used to analyze the data. Among married women in Ethiopia, 29.2% used contraceptive methods. About 44.1% of women who were not current users of contraceptives reported that they intended to use contraceptives in the future. Age at first marriage, being educated, number of living children, exposure to mass media, being employed, having educated partners, and having been informed about contraceptive use at health facilities were positively associated with current contraceptive use. By contrast, older age, a rural resident, or Muslim; belonging to the Afar or Somali ethnic groups; desiring numerous children; having husbands who desired additional children; and abortion experience were negatively associated with current contraceptive use. Our findings indicated that improving education, providing employment opportunities for women, and providing training to family planning providers are essential to increasing contraceptive use. PMID:26212154

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

    ERIC Educational Resources Information Center

    Ryan, Suzanne; Franzetta, Kerry; Manlove, Jennifer

    2007-01-01

    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,

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

    ERIC Educational Resources Information Center

    Ryan, Suzanne; Franzetta, Kerry; Manlove, Jennifer

    2007-01-01

    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,…

  3. [Contraceptive development for the future].

    PubMed

    Zatuchni, G I

    1984-06-01

    This article provides background on worldwide contraceptive usage as an introduction to its main topic, new methods of fertility regulation now under development in terms of their intervention in specific reproductive processes. A large number of chemical compounds and steroidal or nonsteroidal pharmacologic agents have been shown to interfere directly of indirectly with the processes of spermatogenesis, but most are associated with undesirable side effects. Nitrofuranes, alpha-chlorohydrine and othr chlorinated sugars, cyproterone acetate, estrogen, progestins, testosterone alone or in combination with other hormonal agents, and the cotton seed derivative gossypol have all been tested. Although research on some of them continues, questions questions of side effects, toxicity, and reversibility have arisen. Luteinizing hormone releasing hormone analogs and especially antagonists offer promise as a male contraceptive use in conjunction with testosterone, but further research on efficacy and reversibility is needed. Percutaneous vas occlusion using chemical substances including a mixture of ethannol and formaldehyde, and occlusion of the vas by electrocautery are norsurgical techniques of vas occlusion that are expected to be more acceptable to men than current surgical techniques. Various removable devices for vas occlusion have been studies, such as silicone or nylon threads, valves of different kinds, polymers, and threads of metal, especially copper, but thus far all have posed serious technical problems. Methods under development which block sperm transport in the female genital tract include enzyme sperm inhibitors and long-acting steroids, spermicides, improved vaginal sponges, disposable diaphragms impregnated with spermicide, vaginal rings, water soluble spermicidal condoms, a latex cervical cap kept in place by suction, an intracervical device that would liberate progesterone, transcervical approaches to sterilization by occlusion of the salpingo-uterine junction using quinacrine or methylcyanocrylate, and reversible methods of obstructing the salpingo-uterine junction. Research is underway to develop IUDs that would remain effective longer and reduce incidences of bleeding and expulsion, possibly through use of substances such as quinacrine, luteolytic agents, immunologic or spermicidal substances, or antifibrinolytic agents. Long-acting methods including injectable steroids and biodegradable or non-biodegradable implants, pregnancy vaccines, and other immunological approaches are at various stages of research. PMID:12313176

  4. Pregnancy after removal of Norplant implants contraceptive.

    PubMed

    Affandi, B; Santoso, S S; Djajadilaga; Hadisaputra, W; Moeloek, F A; Prihartono, J; Lubis, F; Samil, R S

    1987-08-01

    Many concerns have been expressed regarding the introduction of a new contraceptive method into family planning programmes. One of the concerns is the return of fertility after discontinuing the method. To evaluate the subsequent fertility status of the Indonesian women after removal of Norplant, a prospective longitudinal study was undertaken in Klinik Radeb Saleh, Jakarta. Fifty-one women whose Norplant were removed because of their wish to become pregnant were followed-up for a period of two years or until pregnancy occurred, whichever was earlier. Two groups of women who had Lippes C IUD removed or discontinued the use of DMPA for planning pregnancy served as control and were followed-up for equal length of time. The cumulative conception rate for ex-Norplant users, ex-IUD users and ex-DMPA users at one year was 76.5, 74.7 and 70.2 per 100 women, respectively. There was no significant difference between the groups (p greater than 0.05). The present study, along with other studies, indicate that the prolonged use of Norplant do not impair the return of fertility. PMID:3123134

  5. Domestic Violence, Contraceptive Use, and Unwanted Pregnancy in Rural India

    PubMed Central

    Stephenson, Rob; Koenig, Michael A.; Acharya, Rajib; Roy, Tarun K.

    2009-01-01

    This study examines the relationship between male-to-female physical domestic violence and unwanted pregnancy among women in three economically and culturally diverse areas of India. A central methodological focus of the study is the examination of retrospective and prospective measures of pregnancy unwantedness, contrasting their usefulness for specifying levels of unwanted pregnancy and its relationship with domestic violence. Data from India's 1998–99 National Family Health Survey and a 2002–03 follow-up survey for which women in four states were reinterviewed are analyzed, and the factors associated with the intersurvey adoption of contraception and the experience of an unwanted pregnancy are examined. Women who experience physical violence from their husbands are significantly less likely to adopt contraception and more likely to experience an unwanted pregnancy. A prospectively measured indicator of unwanted pregnancy identifies a higher prevalence of unwanted pregnancies than do the traditionally employed retrospective measures and is more successful in establishing a relationship between unwanted pregnancies and domestic violence. The results demonstrate a clear relationship between a woman's experience of physical violence from her husband and her ability to achieve her fertility intentions. The need to improve the measurement of pregnancy intendedness is clear, and a move toward using prospective measures as the standard is necessary. PMID:18853639

  6. Emergency Contraception: Do Your Patients Have a Plan B?

    PubMed

    Bullock, Holly; Salcedo, Jennifer

    2015-12-01

    Emergency contraception is used after unprotected sex, inadequately protected sex, or sexual assault to reduce the risk of pregnancy. Of emergency contraceptive methods available in the United States, the copper intrauterine device has the highest efficacy, followed by ulipristal acetate, levonorgestrel-containing emergency contraceptive pills, and the Yuzpe method. However, access to the most effective methods is limited. Although advanced prescription of emergency contraceptive pills and counseling on emergency contraception to all reproductive-aged women is recommended, women should be advised to contact their health care providers after taking emergency contraceptive pills to discuss possible copper intrauterine device placement and other follow-up. PMID:26598310

  7. Non-hormonal male contraception: A review and development of an Eppin based contraceptive.

    PubMed

    O'Rand, Michael G; Silva, Erick J R; Hamil, Katherine G

    2016-01-01

    Developing a non-hormonal male contraceptive requires identifying and characterizing an appropriate target and demonstrating its essential role in reproduction. Here we review the development of male contraceptive targets and the current therapeutic agents under consideration. In addition, the development of EPPIN as a target for contraception is reviewed. EPPIN is a well characterized surface protein on human spermatozoa that has an essential function in primate reproduction. EPPIN is discussed as an example of target development, testing in non-human primates, and the search for small organic compounds that mimic contraceptive antibodies; binding EPPIN and blocking sperm motility. Although many hurdles remain before the success of a non-hormonal male contraceptive, continued persistence should yield a marketable product. PMID:26593445

  8. Prevalence, Employment Rate, and Cost of Schizophrenia in a High-Income Welfare Society: A Population-Based Study Using Comprehensive Health and Welfare Registers.

    PubMed

    Evensen, Stig; Wisløff, Torbjørn; Lystad, June Ullevoldsæter; Bull, Helen; Ueland, Torill; Falkum, Erik

    2016-03-01

    Schizophrenia is associated with recurrent hospitalizations, need for long-term community support, poor social functioning, and low employment rates. Despite the wide- ranging financial and social burdens associated with the illness, there is great uncertainty regarding prevalence, employment rates, and the societal costs of schizophrenia. The current study investigates 12-month prevalence of patients treated for schizophrenia, employment rates, and cost of schizophrenia using a population-based top-down approach. Data were obtained from comprehensive and mandatory health and welfare registers in Norway. We identified a 12-month prevalence of 0.17% for the entire population. The employment rate among working-age individuals was 10.24%. The societal costs for the 12-month period were USD 890 million. The average cost per individual with schizophrenia was USD 106 thousand. Inpatient care and lost productivity due to high unemployment represented 33% and 29%, respectively, of the total costs. The use of mandatory health and welfare registers enabled a unique and informative analysis on true population-based datasets. PMID:26433216

  9. Knowledge and attitudes of Latin American obstetricians and gynecologists regarding intrauterine contraceptives

    PubMed Central

    Bahamondes, Luis; Makuch, Maria Y; Monteiro, Ilza; Marin, Victor; Lynen, Richard

    2015-01-01

    Background Intrauterine contraceptives (IUCs), including the copper intrauterine device and the levonorgestrel-releasing intrauterine system (LNG-IUS), are among the reversible contraceptive methods with high effectiveness. However, use is low in many settings, including some Latin American countries, mainly due to the influences of myths, fears, and negative attitudes, not only of users and potential users, but also of different cadres of health care professionals. The purpose of this study was to assess the knowledge and attitudes of a group of Latin American obstetricians and gynecologists regarding IUCs. Methods A survey was conducted during a scientific meeting organized in Chile in 2014 to present and discuss updated information about contraception. Obstetricians and gynecologists from 12 Latin American countries, who reported that they provide daily contraception services in both the public and private sectors, participated in the meeting. Participants who agreed to take part in the survey responded to a multiple-choice questionnaire on issues regarding knowledge, use, and attitudes about IUCs. Results Of the 210 obstetricians and gynecologists participating in the meeting, the respondents to each question varied from 168 (80.0%) to 205 (97.6%). Almost 50% recognized that the failure rate of combined oral contraceptives, patches, and vaginal rings is 8%–10%. Furthermore, 10% of the participants did not recognize the high contraceptive effectiveness of long-acting reversible contraceptive methods. Additionally, almost 80% of the respondents answered that they did not offer IUCs to nulligravidas and almost 10% did not offer IUCs to adolescents, albeit almost 90% of the respondents reported that nulligravidas are candidates for an LNG-IUS. Conclusion Some deficiencies and contradictions in terms of knowledge and attitudes were identified from the answers of the Latin American obstetricians and gynecologists who participated in the survey. The knowledge and attitudes of health care professionals about IUCs are important in order to provide adequate counseling and to expand the use of IUCs. PMID:26213479

  10. Postpartum contraceptive use and unmet need for family planning in five low-income countries

    PubMed Central

    2015-01-01

    Background During the post-partum period, most women wish to delay or prevent future pregnancies. Despite this, the unmet need for family planning up to a year after delivery is higher than at any other time. This study aims to assess fertility intention, contraceptive usage and unmet need for family planning amongst women who are six weeks postpartum, as well as to identify those at greatest risk of having an unmet need for family planning during this period. Methods Using the NICHD Global Network for Women’s and Children’s Health Research’s multi-site, prospective, ongoing, active surveillance system to track pregnancies and births in 100 rural geographic clusters in 5 countries (India, Pakistan, Zambia, Kenya and Guatemala), we assessed fertility intention and contraceptive usage at day 42 post-partum. Results We gathered data on 36,687 women in the post-partum period. Less than 5% of these women wished to have another pregnancy within the year. Despite this, rates of modern contraceptive usage varied widely and unmet need ranged from 25% to 96%. Even amongst users of modern contraceptives, the uptake of the most effective long-acting reversible contraceptives (intrauterine devices) was low. Women of age less than 20 years, parity of two or less, limited education and those who deliver at home were at highest risk for having unmet need. Conclusions Six weeks postpartum, almost all women wish to delay or prevent a future pregnancy. Even in sites where early contraceptive adoption is common, there is substantial unmet need for family planning. This is consistently highest amongst women below the age of 20 years. Interventions aimed at increasing the adoption of effective contraceptive methods are urgently needed in the majority of sites in order to reduce unmet need and to improve both maternal and infant outcomes, especially amongst young women. Study registration Clinicaltrials.gov (ID# NCT01073475) PMID:26063346

  11. Designed Chemical Intervention with Thiols for Prophylactic Contraception

    PubMed Central

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

    2013-01-01

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

  12. Action against contraceptive implant threatened.

    PubMed

    Dyer, C

    1995-08-19

    Norplant provides contraception over a five-year period through the gradual subcutaneous release of the progestogen levonorgestrel. It has been on the US market since 1991 and available in Great Britain since 1993. Already the subject of group legal actions in several US states, Norplant may soon be the target of lawyers in Britain for litigation. The lawyers allege that insertion of the implant under the skin of the upper arm by untrained doctors has led to painful and difficult removals and left women with scarred arms. Moreover, insufficient warning has been given about possible side effects such as mood swings and continuous vaginal bleeding. Hoechst Roussel, marketer of the implant in Britain, however, argues that only doctors trained in Norplant insertion and removal should attempt either procedure. Removal will be problematic only if preceded by a problem insertion. Hoechst Roussel recently advised gynecologists, in writing, not to attempt to extract the implant unless they are trained in the removal technique. By British law, the application of a drug product once approved for general release to general practitioners and family planning doctors cannot be restricted by a pharmaceutical company. PMID:7647639

  13. Adolescents' use of levonorgestrel implants for contraception.

    PubMed

    Spaulding, C

    1996-04-01

    A concern for poor compliance among adolescents using oral contraceptives (OCs) has motivated researchers to evaluate various contraceptive methods. Some researchers recruited 166 sexually active African-American youth aged 12-18, at least one year postmenarche, receiving family planning services at an inner-city comprehensive adolescent clinic or a teen mother and baby clinic, both in Baltimore, Maryland. The three contraceptive methods evaluated were a levonorgestrel-releasing contraceptive implant, OCs, and the condom. Implant users were more likely to have been pregnant in the past than OC and condom users (60% vs. 45% and 35%, respectively). 75% of implant users and OC users had used OCs in the past. 37% of all teens had always used condoms in the last six months. Implant users were just as likely be satisfied with their chosen contraceptive as were OC users. They were less likely to become pregnant than OC and condom users (2% vs. 20% and 17%, respectively). Implant users were more likely than OC users to still be using their chosen contraceptive at six months (87% vs. 50%). They were more likely than OC users to report irregular menses, mood swings, acne, and hair loss. 22% of OC users took their pills every day during the last six months. In fact, most teens who discontinued OCs forgot to take pills. Based on these findings, family practice physicians are advised to consider levonorgestrel implants for sexually active teens, especially those with a previous pregnancy or difficulty complying with other contraceptive methods. Regardless of method chosen, they should encourage sexually active teens to use condoms to protect against sexually transmitted diseases. PMID:8627198

  14. [Chen Muhua holds meeting on contraceptives].

    PubMed

    1981-02-26

    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

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

    PubMed Central

    Omland, G; Ruths, S; Diaz, E

    2014-01-01

    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 1645years, 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 893073 women were included, of whom 130080 were immigrants. More native women (38%) used hormonal contraceptives compared with all immigrant groups (1524%). 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

  16. Counseling on contraceptives: an unfilled need.

    PubMed

    Steadman, S

    1985-09-01

    The dictum that pharmacists have a fundamental responsibility to provide health care information for their patients includes the need to furnish complete and accurate information on all of the contraceptive products that currently are on the market. To help accomplish this, many different resources are available that provide guidance for comprehensive patient education on all the different products and devices. If one agrees to the principle that an individual's sexuality is an accepted element of his or her life, then promoting sexual well-being should be an important part of health care. Yet, it seems that pharmacists and other health care professionals in general have not been particularly liberated about talking about and making objective assessments on sexual matters. Health care professionals seem to need more education to enable them to provide accurate information, to augment their own knowledge bases, and to reduce their inhibitions and possible misconceptions about sexual matters. Pharmacists do not want to appear as if they are encouraging or promoting sexual activity, but, given the consequences of nonuse of contraception, socially responsible pharmacists need to disseminate basic information about the use of contraceptive products. At some level, too, objective guidelines should be established to help pharmacists in handling contraceptive information. Pharmacists can play a key role in counseling on both prescription and nonprescription methods. In fact, pharmacists may be the only health care professionals with whom a sexually active person can speak about nonprescription contraceptive methods. Some pharmacists have been reluctant to provide patient information because of the risk of possible liability. But this attitude seems to be changing. The recent emphasis on clinical functions in pharmacy practice has led to speculation that, as pharmacists come to assume new roles, they may become liable for not providing some of this information. At present, at least 22 states already have guidelines or regulations requiring pharmacists to counsel patients. To provide the most effective learning experience, active participation is the key ingredient. It is necessary to elicit active participation in the counseling process. It is not possible to give complete guidance on the subject of contraceptives to every patient that comes in the store. Nor is every person going to be receptive, at least initially, to the idea of talking about contraception with a pharmacist. Yet, the role of the pharmacist takes on greater significance now because of the controversy that continues to surround some of the safety and efficacy issues of oral contraceptives and IUDs. Brochures and other materials are available to help pharmacists counsel patients on all of the different contraceptive methods. PMID:4050672

  17. Zoely: a new combined oral contraceptive.

    PubMed

    2014-08-01

    ▼Zoely is the second estradiol-containing oral contraceptive formulated as an 'extended regimen' (pill-free interval <7 days) to be licensed in the UK. However, unlike the quadraphasic estradiol-containing contraceptive Qlaira, it is a monophasic preparation.1,2 It is postulated that combined oral contraceptives (COCs) containing synthetic estradiol, which is structurally identical to endogenous oestrogen,3 are potentially safer and better tolerated than those containing ethinylestradiol, the synthetic oestrogen most commonly used in COCs.4 The progestogen in Zoely is nomegestrol acetate, which is structurally related to progesterone,5 in contrast to the majority of progestogens in COCs that are derived from 19-nortestosterone6 and associated with androgenic effects.7 It is suggested that nomegestrol acetate, with its greater specificity for progesterone receptors, may minimise the potential for androgenic, oestrogenic and glucocorticoid effects.7 The company considers Zoely an option for women "who want a contraceptive with hormones similar to her own", and claims that it has a high level of contraceptive efficacy, produces shorter, lighter periods compared with a 21-day regimen of drospirenone 3mg/ethinylestradiol 30µg (Yasmin) and that most women report no negative impact on weight and skin.8 Here we review the effectiveness and place of Zoely. PMID:25104773

  18. Practices of prescribing oral contraceptives in Poland.

    PubMed

    Lech, M M; Swiatek, E J

    2001-03-01

    We developed and performed a survey on practices of prescribing oral contraceptives in Poland. The survey was carried out in Warsaw, the capital city of Poland and one of the most important areas of the country (approximately 4 million inhabitants). The main aim of the study was to recognize the rationale and practices of prescribing oral contraceptives by gynecologists in Poland (oral contraceptives are prescribed mostly by gynecologists, not by general practitioners or midwives). The questions were sent to all members of Warsaw's Association of Gynecologists, but we have received back only 276 answers (79% of the total number of members) and the responses are presented here. The responses revealed that the most popular oral contraceptives are those modern formulations combining low doses of ethinylestradiol and progestogens such as norgestimate, desogestrel, gestodene and levonorgestrel. For gynecologists, the most important factors in the selection of an oral contraceptive were the dose of hormones (20.3%), the formulation (18.5%), tolerance by patients (23.5%) and past clinical experience with the formulation (9.4%). The price was most important for 3.7%, and good marketing practices were most important for 8.3% of the gynecologists. PMID:11334473

  19. The career woman and oral contraceptive use.

    TOXLINE Toxicology Bibliographic Information

    Sulak PJ

    1991-01-01

    The benefits of oral contraceptives are emphasized in this review, which begins by listing the priorities an older career woman seeks in a contraceptive. She needs a highly reliable, reversible method while she postpones childbearing until as late as age 35, with no long-term adverse effects. The method must not affect cardiovascular health or fertility, nor increase risk of endometrial or ovarian cancer. Polls indicate that many women believe the pill has serious health risks, causes cancer, and is not very reliable. Actually it is almost as reliable as sterilization, has no lasting effect on fertility, adds no risk of cardiovascular disease if patients are screened for risk factors, and probably does not increase the change of getting breast cancer in most women. The non-contraceptive benefits of oral contraceptives are significant to health: protection against endometrial and ovarian cancer, heavy menses, dysmenorrhea, ovarian cysts, reduced risk of pelvic inflammatory disease, endometriosis, benign breast disease, iron deficiency anemia, and osteoporosis. With today's low-dose pills and proper screening of patients, most practitioners will never see a major complication. The Food and Drug Administration has lengthened the approved use of oral contraceptives in health non-smokers up to menopause.

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

    PubMed

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

    2016-01-01

    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

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

    PubMed

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

    2010-06-01

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

  2. Search for an Emergency Contraception Provider in the United States

    MedlinePlus

    ... Contraception Website - Your website for the "Morning After" Search for an Emergency Contraception (Plan B) Provider in ... use ella (a prescription-only product) you can search our directory for health care providers (including pharmacists ...

  3. Knowledge, awareness, and perception of contraception among senior pharmacy students in Malaysia: A pilot study

    PubMed Central

    Elkalmi, Ramadan M.; Khan, Muhammad Umair; Ahmad, Akram; Srikanth, Akshaya B.; Abdurhaman, Norny Syafinase; Jamshed, Shazia Q.; Awad, Ammar Ihsan; Binti Ab Hadi, Hazrina

    2015-01-01

    Objective: This study aimed to assess the knowledge, awareness, and perception of contraception among senior pharmacy students of a public sector university in Malaysia. Methods: A cross-sectional, questionnaire-based study was conducted among senior pharmacy students. The pretested questionnaire was used to collect data from the participants over the period of 1-month. The questionnaire was divided into four sections, for gathering the information about students’ demographic data, and their knowledge, attitudes, and perception toward contraception. Data were statistically analyzed using SPSS version 20. Findings: The response rate was 68.6%. The results showed that the contraceptive knowledge was comparatively higher in year four students (P < 0.001), married respondents (P < 0.001) and those taking elective courses (P = 0.022) as compared to their respective counterparts. Majority of the students were well aware and had a positive perception about contraception. Conclusion: Overall findings reflect that the majority of the students had good knowledge, perception, and awareness about contraception. The study recommends future studies to be conducted covering different pharmacy schools across the country to further establish the results. PMID:25984548

  4. Selection of oral contraceptives or hormone replacement therapy: patient communication and counseling issues.

    PubMed

    La Valleur, J; Wysocki, S

    2001-08-01

    Oral contraceptives and combination hormone replacement therapy are underused by most women. Among users, lack of compliance/adherence to oral contraceptive or hormone replacement therapy regimens can lead to discontinuation and deprive women of the full range of benefits achieved through hormone continuity. To prevent unintended pregnancy and to improve the health outcomes of women of all ages and the overall quality of life, adherence and continuation rates need to be improved for oral contraceptive and hormone replacement therapy use. Effective communication and counseling during the oral contraceptive and hormone replacement therapy regimen selection process and subsequent follow-up interactions are essential. Patients need to be informed in a clear and concise manner that, for most women, the benefits of oral contraceptives and hormone replacement therapy outweigh any associated health risks. Data should be presented without epidemiologic jargon and in terms that are easily understood. It is recommended that realistic expectations concerning the possible side effects, especially during the initial use of hormones, are established before use; furthermore, the selection of a formulation should take into account the unique needs of each patient. PMID:11521123

  5. Oral contraceptives and breast cancer.

    PubMed

    Kalache, A; McPherson, K; Barltrop, K; Vessey, M P

    1983-10-01

    An attempt is made to summarize the results of recently conducted epidemiological studies relating to the possible adverse effects of oral contraceptives (OCs) on breast cancer. Evaluation of the safety of OCs is difficult. An important reason is that since preparations were introduced to the American market in 1959 the formulation of pills and the dosage of constituents have both changed markedly. A number of other considerations to be born in mind when evaluating the relevant literature were identified by a recent World Health Organization (WHO) Scientific Group. These include the following: there is usually a considerable latent period between 1st exposure to a carcinogen and the development of overt malignancy; and it is possible that exposure to contraceptive steroids may be particularly important at certain critical periods during reproductive life. After age, the most important risk factors during early life are a young age at menarche and a late age at 1st full term birth. There factors appear to operate independently and so the longer the period between menarche and 1st full term birth, the higher is the risk of breast cancer. A girl whose menarche occurs before age 12 is approximately twice as likely to develop breast cancer later in life as a girl whose menarche occurs after age 14. Similarly, a woman whose first full term birth occurs after age 35 is about 3 times more likely to develop breast cancer than a woman who gives birth before age 20. Nulliparous women have an intermediate risk. Other known risk factors include a family history of breast cancer, a past history of benign breast disease, and increased body weight. Possibly the most serious problem from an epidemiological perspective is the interrelationship between calendar time, age, and OC exposure. OC seems to be clearly associated with a decreased risk of benign breast disease of sufficient severity to require biopsy and the evidence is that the reduction in risk increases with duration of use. The epidemiological evidence available regarding OCs and breast cancer is reassuring. Data have been obtained from case control studies and cohort studies. A table summarizes the main features of 12 case control studies. Results of both groups of studies are reassuring in relation to breast cancer, yet there is usually a long period between exposure to a carcinogen and the development of overt malignancy and OCs have been in widespread use for only a relatively short time. Women who have never used OCs seem to present with more clinically advanced tumors than women who have used them. The differences in staging are reflected in patterns of survival. The difference may be due to a greater awareness of breast disease in OC users, but it could represent a beneficial biological effect of OCs. PMID:6640197

  6. Contraceptive implants: long acting and provider dependent contraception raises concerns about freedom of choice.

    PubMed

    Thompson, M S

    1996-11-30

    David Bromham's editorial on contraceptive implants ignores the wider issues to voice concern that trial by media could limit contraceptive choice by jeopardising research into new methods. However, it is more beneficial to the public for points of conflict to be debated openly. Furthermore, the impetus for research into new contraceptive technology is driven by profit and political motives and is only marginally affected by the media. Implanted contraceptives may increase the choice of contraceptive methods, but they put control of fertility increasingly into the hands of the medical profession. Herein lies their greatest problem: their potential to increase providers' control over clients' choice. There is the danger that certain groups of women may be targeted for their use: in the United States the coercive use of Norplant for mothers receiving welfare benefit has been suggested. Long acting contraceptives are a contraceptive of choice only when they are available without pressure, as part of a wider menu; when instant removal on request is guaranteed; and when there is an open and free flow of information and opinions between users, health professionals, and special interest groups. PMID:8956712

  7. Induced abortion and contraception use

    PubMed Central

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

    2014-01-01

    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

  8. New progestagens for contraceptive use.

    PubMed

    Sitruk-Ware, Regine

    2006-01-01

    The progestins have different pharmacologic properties depending upon the parent molecule, usually testosterone or progesterone (P), from which they are derived. Very small structural changes in the parent molecule may induce considerable differences in the activity of the derivative. In hormonal contraceptives, progestins represent the major agent designed for suppressing ovulation and are used in combination with estrogen (E) usually ethinyl-estradiol (EE). The development of new generations of progestins with improved selectivity profiles has been a great challenge. Steroidal and nonsteroidal progesterone receptor (PR) agonists have been synthesized as well, although the latter are still in a very early stage of development. Several new progestins, have been synthesized in the last two decades. These include dienogest (DNG), drospirenone (DRSP), Nestorone (NES), nomegestrol acetate (NOMAc) and trimegestone (TMG). These new progestins have been designed to have no androgenic or estrogenic actions and to be closer in activity to the physiological hormone P. DRSP differs from the classic progestins as it is derived from spirolactone. It is essentially an antimineralocorticoid steroid with no androgenic effect but a partial antiandrogenic effect. The antiovulatory potency of the different progestins varies. TMG and NES are the most potent progestins synthesized to date, followed by two of the older progestins, keto-desogestrel (keto-DSG) and levonorgestrel (LNG). The new molecules TMG, DRSP and DNG also have antiandrogenic activity. Striking differences exist regarding the side effects among the progestins and the combination with EE leads to other reactions related to the E itself and whether the associated progestin counterbalances, more or less, the estrogenic action. The 19-norprogesterone molecules and the new molecules DRSP and DNG are not androgenic and, therefore, have no negative effect on the lipid profile. Given their pharmacological properties, it is likely that the new progestins may have neutral effects on metabolic or vascular risks. However, this hypothesis must be confirmed in large clinical trials. PMID:16291771

  9. The contribution of school-level factors to contraceptive use among adolescents in New York city public high schools

    NASA Astrophysics Data System (ADS)

    Kaplan, Deborah L.

    Every year approximately 17,000 adolescents ages 15-19 become pregnant in New York City. Most of these pregnancies are unintended and only a small percent of adolescents use effective contraception, with wide disparities by race/ethnicity and poverty level. While many studies have identified factors associated with contraceptive use, most research has focused on individual level factors, with little attention to the contribution of the school environment to sexual risk behavior and contraceptive use. This study investigates the effect of school-level factors on contraceptive use among adolescents in NYC public high schools before and after controlling for individual-level factors, and whether this effect varies with race/ethnicity. Using a cross-sectional design, the NYC Youth Risk Behavior Survey (YRBS) individual-level datasets for 2007, 2009 and 2011 were linked to a school-level dataset. Variables were selected based on empirical findings on factors associated with sexual behaviors, including contraceptive use, by adolescents. The analytic sample included all YRBS respondents aged 14 or older who reported having sexual intercourse in the past three months and had complete responses to the YRBS questions on contraceptive use at last sex (N=8,054). The chi square test of significance was used to evaluate significant associations between independent variables and contraceptive use in bivariate analyses; variables with a p value < 0.1 were included in the multivariable analyses. Binary and multinomial logistic regression analyses were conducted to estimate the strength of the associations of school-level factors with contraceptive use among sexually active adolescents. Findings included that use of any contraception and/or hormonal contraception at last sexual intercourse was associated with attending schools with a higher six-year graduation rate, higher percent of students strongly agreeing they were safe in their classrooms, higher percent of teachers at the school for over two years, and having a School-Based Health Center (SBHC) in the building. No known study has examined the contribution of school-level effects to contraceptive use in a dataset linking YRBS and school-level datasets. Implications of research findings are that schools providing a supportive, engaging and safe environment can protect students from sexual risk behaviors and increase contraceptive use among sexually active adolescents.

  10. Contraceptive issues of youth and adolescents in developing countries: highlights from the Philippines and other Asian countries.

    PubMed

    Alesna-Llanto, Emma; Raymundo, Corazon M

    2005-10-01

    This article highlights contraceptive issues in Asia, home to some 700 million adolescents. It starts with a description of the socio-cultural milieu of adolescents in South and Southeast Asia, their knowledge and use of contraceptives, the myriad barriers to access, and the many innovative programs to broaden contraceptive availability. The reproductive health needs of adolescents in poor countries cannot be solved by merely supplying them with contraceptives--these needs can only be fully addressed in the context of gender equality, poverty alleviation and the conviction that investing in the reproductive health of adolescents is a most urgent priority. Investing in the reproductive health of adolescents will have an impact not only on birth and abortion rates, maternal health, and the spread of STI/HIV but also on the demographics and economic development of the region--and beyond. PMID:16183545

  11. A randomized double-blind trial of two low dose combined oral contraceptives.

    PubMed

    Bounds, W; Vessey, M; Wiggins, P

    1979-04-01

    Fifty-five women using Loestrin-20 (20 microgram ethinyl oestradiol and 1 mg norethisterone acetate) as an oral contraceptive have been compared with a like number using Microgynon-30 (30 microgram ethinyl oestradiol and 150 microgram levonorgestrel) in a randomized, double-blind trial. Despite the small sample size, the main finding in the trial is clear-cut; Loestrin-20 provides poor cycle control and is thus less acceptable as an oral contraceptive than Microgynon-30. Although there is also a suggestion that Loestrin-20 may be less effective than Microgynon-30, the difference in the accidental pregnancy rates is not statistically significant. PMID:373792

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

    PubMed

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

    2014-06-01

    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

  13. Asymptomatic bacteriuria: prevalence rates of causal microorganisms, etiology of infection in different patient populations, and recent advances in molecular detection.

    PubMed

    Ipe, Deepak S; Sundac, Lana; Benjamin, William H; Moore, Kate H; Ulett, Glen C

    2013-09-01

    Bacteriuria, or the presence of bacteria in urine, is associated with both asymptomatic and symptomatic urinary tract infection and underpins much of the dynamic of microbial colonization of the urinary tract. The prevalence of bacteriuria in dissimilar patient groups such as healthy adults, institutionalized elderly, pregnant women, and immune-compromised patients varies widely. In addition, assessing the importance of 'significant bacteriuria' in infected individuals represents a diagnostic challenge, partly due to various causal microorganisms, and requires careful consideration of the distinct etiologies of bacteriuria in different populations and circumstances. Recent molecular discoveries have revealed how some bacterial traits can enable organisms to grow in human urine, which, as a fitness adaptation, is likely to influence the progression of bacteriuria in some individuals. In this review, we comprehensively analyze currently available data on the prevalence of causal organisms with a focus on asymptomatic bacteriuria in dissimilar populations. We evaluate recent advances in the molecular detection of bacteriuria from a diagnostic viewpoint and briefly discuss the potential benefits and some of the challenges of these approaches. Overall, this review provides an update on the comparative prevalence and etiology of bacteriuria from both microbiological and clinical perspectives. PMID:23808987

  14. Contraceptive Adoption, Discontinuation, and Switching among Postpartum Women in Nairobi's Urban Slums.

    PubMed

    Mumah, Joyce N; Machiyama, Kazuyo; Mutua, Michael; Kabiru, Caroline W; Cleland, John

    2015-12-01

    Unmet need for contracepti