Sample records for contraceptive prevalence rate

  1. Effect of village midwife program on contraceptive prevalence and method choice in Indonesia.

    PubMed

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

    2013-12-01

    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

  2. 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.

  3. On the determination of contraceptive prevalence using health care utilization data.

    PubMed

    Edouard, L

    1997-04-01

    A potential application of health care utilization databases is in the determination of contraceptive prevalence. A model linking specific factors concerning the utilization of modern methods of family planning has been developed to estimate contraceptive prevalence by age group for Saskatchewan. The limitations of these estimations of contraceptive prevalence are discussed. PMID:9179107

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

    PubMed Central

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

    2014-01-01

    Introduction In Ethiopia, knowledge of contraceptive methods is high though there is low contraceptive prevalence rate. This study was aimed to assess prevalence and associated factors of long acting and permanent contraceptive methods in Jinka town, southern Ethiopia. Methods Community based cross sectional survey was conducted to assess the prevalence and factors affecting long acting and permanent methods of contraceptives utilization from March to April 2008. Eight hundred child bearing age women were participated in the quantitative study and 32 purposively selected focus group discussants were participated in the qualitative study. Face to face interview was used for data collection. Data were analyzed by SPSS version 13.0 statistical software. Descriptive statistics and logistic regression were computed to analyze the data. Results The prevalence of long acting and permanent contraceptive method was 7.3%. Three fourth (76.1%) of the women have ever heard about implants and implant 28 (50%) were the most widely used method. Almost two third of women had intention to use long acting and permanent methods. Knowledge of contraceptive and age of women have significant association with the use of long acting and permanent contraceptive methods. Conclusion The overall prevalence of long acting and permanent contraceptive method was low. Knowledge of contraceptive and age of women have significant association with use of long acting and permanent contraceptive. Extensive health information should be provided. PMID:25404960

  5. 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.

  6. Contraception

    Microsoft Academic Search

    Ruth Levine; Ana Langer; Nancy Birdsall; Gaverick Matheny; Merrick Wright; Angela Bayer

    The use of modern contraception to prevent pregnancies is a unique health intervention because, in many ways, it is not a health intervention at all. In general, couples in sexual relation- ships use contraception because, at the time the decision is made, one or both members do not wish to conceive a child, rather than because they wish to become

  7. 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

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

    E-print Network

    Field, Layton Marshall

    2014-06-06

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

  9. 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

  10. The Creeping Pearl: Why Has the Rate of Contraceptive Failure Increased in Clinical Trials of Combined Hormonal Contraceptive Pills?

    PubMed Central

    Trussell, James; Portman, David

    2013-01-01

    BACKGROUND Despite several drawbacks, the Pearl Index continues to be the most widely used statistical measure of contraceptive failure. However, Pearl indices reported in studies of newer hormonal contraceptives appear to be increasing. STUDY DESIGN We searched PubMed and MIS databases for prospective trials evaluating oral contraceptive (OC) efficacy to examine potential factors that could contribute to increasing Pearl indices. RESULTS Numerous potential factors were identified, including an increased rate of failures of newer OCs, deficiencies in methods of calculating contraceptive failure rates, differences in study design and changes in patient populations resulting in increased rates of contraceptive failures due to the inappropriate or inconsistent use of the method. CONCLUSIONS The two most likely important contributors to the increase in Pearl indices are more frequent pregnancy testing with more sensitive tests and less adherent study populations. Because study populations appear to be increasingly representative of the likely actual users once the product is marketed, we can expect to see even higher failure rates in ongoing and future studies. This result poses challenges for companies and regulatory agencies. PMID:23683581

  11. Emergency contraception.

    PubMed

    2012-12-01

    Despite significant declines over the past 2 decades, the United States continues to have teen birth rates that are significantly higher than other industrialized nations. Use of emergency contraception can reduce the risk of pregnancy if used up to 120 hours after unprotected intercourse or contraceptive failure and is most effective if used in the first 24 hours. Indications for the use of emergency contraception include sexual assault, unprotected intercourse, condom breakage or slippage, and missed or late doses of hormonal contraceptives, including the oral contraceptive pill, contraceptive patch, contraceptive ring (ie, improper placement or loss/expulsion), and injectable contraception. Adolescents younger than 17 years must obtain a prescription from a physician to access emergency contraception in most states. In all states, both males and females 17 years or older can obtain emergency contraception without a prescription. Adolescents are more likely to use emergency contraception if it has been prescribed in advance of need. The aim of this updated policy statement is to (1) educate pediatricians and other physicians on available emergency contraceptive methods; (2) provide current data on safety, efficacy, and use of emergency contraception in teenagers; and (3) encourage routine counseling and advance emergency-contraception prescription as 1 part of a public health strategy to reduce teen pregnancy. This policy focuses on pharmacologic methods of emergency contraception used within 120 hours of unprotected or underprotected coitus for the prevention of unintended pregnancy. Emergency contraceptive medications include products labeled and dedicated for use as emergency contraception by the US Food and Drug Administration (levonorgestrel and ulipristal) and the "off-label" use of combination oral contraceptives. PMID:23184108

  12. services on contraceptive use and abortion rate among young women in China: a cluster randomised trial

    Microsoft Academic Search

    Jin Liang Zhu; Wei-Hong Zhang; Yimin Cheng; Juncai Xux; Xiao Xuþ; Diana Gibson; Henrik Støvring; Patricia Claeys; Marleen Temmerman

    Objectives To compare two post-abortion family planning (FP) service packages on contraceptive use and repeat abortion rate among young women in three cities in China. Methods In this cluster-randomized trial, one FP service package included provision of limited information and referral to existing FP services, and the other, more comprehensive, package consisted - in addition to the above simple package

  13. 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

  14. [Orthorectic eating behaviour - nosology and prevalence rates].

    PubMed

    Barthels, Friederike; Pietrowsky, Reinhard

    2012-12-01

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

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

    PubMed Central

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

    2014-01-01

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

  16. 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 18–44 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

  17. Socioeconomic factors associated with contraceptive use and method choice in urban slums of Bangladesh.

    PubMed

    Kamal, S M Mostafa

    2015-03-01

    This article explores the socioeconomic factors affecting contraceptive use and method choice among women of urban slums using the nationally representative 2006 Bangladesh Urban Health Survey. Both bivariate and multivariate statistical analyses were applied to examine the relationship between a set of sociodemographic factors and the dependent variables. Overall, the contraceptive prevalence rate was 58.1%, of which 53.2% were modern methods. Women's age, access to TV, number of unions, nongovernmental organization membership, working status of women, number of living children, child mortality, and wealth index were important determinants of contraceptive use and method preference. Sex composition of surviving children and women's education were the most important determinants of contraceptive use and method choice. Programs should be strengthened to provide nonclinical modern methods free of cost among the slum dwellers. Doorstep delivery services of modern contraceptive methods may raise the contraceptive prevalence rate among the slum dwellers in Bangladesh. PMID:21914707

  18. 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

  19. Trends in population and contraception.

    PubMed

    Segal, S J

    1993-02-01

    There has been an explosion in contraceptive use in the past 30 years. In 1960-65, the level of contraceptive use in the developing countries of Asia, Latin America and Africa represented about 9% of married couples of reproductive age. In the 1990s use of contraception in developing countries comprises over 50% of couples and contraceptive prevalence is increasing each year. Total fertility rates for the developing world have already fallen from over 6, where they were in 1960 to about 4, halfway toward the replacement level of 2.1. The United Nations projects that during this decade, over 90 million people will be added each year to world population. If this projection is not to be exceeded, prodigious supplies of contraceptives will have to be available at affordable cost to the people of developing countries, where 94% of this population increase will occur. New technology alone will not guarantee this success, but it would help ensure that people are able to meet their fertility objectives. PMID:8435189

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

    Microsoft Academic Search

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

    1996-01-01

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

  1. Contraceptive retail surveys locate problems of acceptance.

    PubMed

    1985-01-01

    Family Health International (FHI) will conduct surveys of contraceptive retail sales in Honduras and Nepal to provide information for policymakers and family planning service providers on how to increase th low levels of contraceptive prevalence and user satisfaction and how to improve use--effectiveness and continuation rates in the 2 countries. Data from the 1984 Maternal Child Health and Family Planning Survey show that contraceptive use has increased markedly in Honduras in the last 3 years, from 27% of married women aged 12-44 in 1981 to 35% in 1984, but the use of oral contraceptives (OCs) remained the same (11% in 1981 and 12% in 1984). A reason for this may be the high cost of OCs. ASHONPLAFA, a private Honduran family planning association, provides contraceptives at low cost through community-based distribution programs in an effort to increase use among poor women. Recently a Social Marketing Program was created to increase accessibility of contraceptives for middle and lower income women. 43% of all contraceptors in Honduras use OCs. The Social Marketing Program offers the OC Perla at less than half the cost of the commercial sector. Perla is sold at approximately 340 pharmacies and health stores, and the Program hopes to expand the number of distribution outlets. Women who discontine OC use usually blame side effects. The FHI survey will interview 500 Perla users and 1500 users of other brands at the time of purchase in 18 of the 340 pharmacies and health stores where Perla is sold. It will determine what Perla users know about OCs and compare it with the knowledge of the users of other brands. The survey also will determine the contraceptive status of women before they began using Perla and compare it with the contraceptive status of non-Perla users. In Nepal there appears to be a great unmet need for family planning services. The government and local private organizations are working to meet the demands of couples. The Nepal Contraceptive Retail Sales company is a private organization that assists government-sponsored family planning by making services available through their medical shops and general stores. Education and motivation of retailers and contraceptive users is a high priority of the program. The FHI-supported survey will sample retailers and consumers from a large number of the medical shops to determine their knowledge, attitudes, and use of certain contraceptives sold at the outlets. The study also will assess the retailers' training the family planning and the need for more information and training. As in Honduras, the Nepal survey will enable policymakers to structure programs to increase contraceptive prevalence through improvements in the marketing and delivery of family planning services. PMID:12340326

  2. Factors affecting use of contraception in Matlab, Bangladesh.

    PubMed

    Khan, M A

    1996-07-01

    This study examines the relationship between family planning, perceived availability of contraceptives, and sociodemographic factors in rural Bangladesh. Data are from the 1990 KAP survey in the Matlab treatment and comparison areas, using a sample of about 8500 married women of reproductive age. The contraceptive prevalence rate was 57% in the treatment area but substantially lower in the comparison area where mainly traditional methods of family planning were used by women who did not know of a source of supply of contraceptives. Education has no effect on contraceptive use in the treatment area but in the comparison area, modest but consistent differentials in use by level of education were found. Number of living children is the best predictor for contraceptive use, followed by number of living sons, and the attitude of respondents and their husbands towards family planning. PMID:8698707

  3. Emergency Contraception

    MedlinePLUS

    ... contraception are available: emergency contraceptive pills and the copper-containing intrauterine device (IUD). Emergency contraceptive pills include ... for emergency use, talk to your doctor. The copper-containing IUD (brand name: Paragard) is a small, ...

  4. Emergency Contraception

    MedlinePLUS

    ... have used emergency contraception pills? • How is the copper intrauterine device (IUD) used as emergency contraception? • Glossary ... your next menstrual period starts. How is the copper intrauterine device (IUD) used as emergency contraception? The ...

  5. Emergency Contraception

    MedlinePLUS

    ... Guy's Guide to Body Image Emergency Contraception KidsHealth > Teens > Sexual Health > Birth Control > Emergency Contraception Print A A A ... using emergency contraception. It is also available to teens who are forced to have unprotected sex. Emergency contraception is not recommended for girls who ...

  6. Understanding unmet contraceptive needs among rural Khasi men and women in Meghalaya.

    PubMed

    Oosterhoff, Pauline; Dkhar, Badalam; Albert, Sandra

    2015-10-01

    There is a global push for increased access to contraception to respond to unmet contraceptive needs. Meghalaya state, with a majority of Indigenous people, has one of the highest unmet contraceptive needs and the lowest contraceptive prevalence rates in India. This qualitative study explores the reasons for the low uptake of contraceptives among Khasi people in a rural district. While policy makers assume that individuals may not be practising family planning because of religion and lack of education, couples actually do use a variety of 'natural' or 'traditional' contraceptive methods to obtain their desired family composition and size. Health providers focus on the provision of hormonal contraceptives, such as the pill, and on technologies such as IUDs and tubectomies that require regular follow-ups by trained medical staff. Health concerns, distrust of contraceptive technologies, the inadequate local health system and a desire to have more than two children are important factors in the low uptake of available contraceptive technologies. Contraceptive choices in rural areas are shaped by the historically problematic political engagement of Indigenous people with the central state, with policy implementation taking place on the basis of widespread assumptions rather than on evidence from contextually relevant behavioural sciences research. PMID:26109041

  7. Contraception among adolescents in Bangladesh.

    PubMed

    Islam, M M; Mahmud, M

    1995-03-01

    Data from the 1989 Bangladesh Fertility Survey were used to investigate the contraceptive behavior of married adolescents (age range: 10-19 years) in comparison with that of married adults. Marriage occurs at an early age in Bangladesh and is almost universal. Thus, adolescent fertility contributes substantially to overall fertility. The 11,906 women interviewed included 1922 (16.1%) adolescents. Knowledge of family planning (FP) was almost universal among both groups, with specific knowledge about methods slightly lower among adolescents. Ever use of a method was reported by 26.3% of the adolescents and 48.4% of the adults. The contraceptive prevalence rate was 15.3% among adolescents (10.7% modern and 4.6% traditional methods) and 34.4% for adults (10.5% female sterilization, 9.9% oral contraceptives, and 6.4% traditional methods). Little difference was found in the attitudes towards contraceptives of adults and adolescents. 83% of adolescents and 58% of adults indicated an intention to use a method in the future. When attitudes about family size were indecisive, contraceptive usage was very low. Logistic regression analysis revealed that increased education is the most important factor having a positive effect on the contraceptive use rate for adolescents, followed by participating in family decision-making, frequency of visits by FP workers, region of residence, husband's occupation, and availability of electricity in the household. The policy implication of these findings are that as women's status improves with increased opportunities for education and employment, they will find ways to meet their contraceptive needs. Also, the popularity of traditional methods could be exploited by program managers, since traditional methods can be effective if taught properly and used consistently. Adolescents need to become aware of the negative consequences of early marriage, early pregnancy, and large family size, they need information on the availability of FP methods and their use-effectiveness, they need improved reproductive health care services which are readily available, and they would benefit from programs designed to overcome the resistance of older family members and husbands to FP. PMID:12319482

  8. PREVALENCE RATE OF PORCINE ROTAVIRUS IN DANISH SWINE HERDS

    E-print Network

    Paris-Sud XI, Université de

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

  9. Contraception and cardiovascular disease.

    PubMed

    Roos-Hesselink, Jolien W; Cornette, Jerome; Sliwa, Karen; Pieper, Petronella G; Veldtman, Gruschen R; Johnson, Mark R

    2015-07-14

    Contraceptive counselling should begin early in females with heart disease, preferably directly after the start of menstruation. In coming to a decision about the method of contraception, the following issues should be considered: (i) the risk of pregnancy for the mother and the consequences of an unplanned pregnancy; (ii) the risks of the contraceptive method; (iii) failure rates; (iv) the non-contraceptive benefits; (v) the availability; (vi) the individual's preferences; (vii) protection against infection; and (viii) costs. In some women with heart disease, the issues may be complex and require the input of both a cardiologist and an obstetrician (or other feto-maternal expert) to identify the optimal approach. No studies have been performed in women with heart disease to investigate the relative risks and benefits of different contraceptive methods. PMID:25926560

  10. Patterns of contraceptive use among urban women in Taiwan

    Microsoft Academic Search

    Dona J. Lethbridge; Rosemary Wang

    1991-01-01

    Patterns of contraceptive use among married urban women in Taiwan were investigated. A convenience sample of 150 women attending health clinics for reasons other than contraceptive care were interviewed about their contraceptive use. The most prevalent contraceptive method used by these women was the intrauterine device, followed by the condom and birth?control pills. Participants had used only one or two

  11. 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…

  12. Obesity and hormonal contraceptive efficacy

    PubMed Central

    Robinson, Jennifer A; Burke, Anne E

    2014-01-01

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

  13. Contraceptive Ring

    Microsoft Academic Search

    Susan A. Ballagh

    In development for more than 20 years, the first vaginal ring contraceptive (NuvaRing®) was approved by the Food and Drug\\u000a Administration in 2001 and marketed in 2002. Like oral contraceptive (OC) pills, the ring is safe, effective, and rapidly\\u000a reversible (1). It offers the lowest estrogen dose of any estrogenprogestin contraceptive product marketed in the United States. It is\\u000a worn

  14. Unexpectedly low prevalence rates of IBS among adult Israeli Jews.

    PubMed

    Sperber, A D; Shvartzman, P; Friger, M; Fich, A

    2005-04-01

    The irritable bowel syndrome (IBS) and other functional bowel disorders (FBDs) are common functional gastrointestinal disorders. The prevalence of IBS using Rome II criteria is generally lower than with previous criteria. The aim of this study was to determine the prevalence of IBS and other FBDs in the adult Israeli Jewish population, which has not been surveyed to date. A telephone survey was conducted on a representative sample of the study population provided by the Israel Ministry of the Interior. IBS and other FBDs were diagnosed by Rome II criteria. The study population was 981 individuals and the overall response rate was 54%. The mean age was 45.0 years and 55% were females. In all, 2.9% had IBS (females: 3.7%, males: 1.8%, P = 0.08). The rate increased to 4.1% when the Rome II diagnostic criteria were amended to include some chronic alternators who are not picked up by the original scoring system. Approximately 26% of the respondents had a functional lower gastrointestinal (GI) disorder (females: 32.1%, males: 17.7%, P < 0.0001). Prevalence rates for IBS among Israeli Jewish adults are lower than rates reported from most countries, despite the high level of stress resulting from Israel's geopolitical circumstances. Possible reasons for this low prevalence are discussed. PMID:15787941

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

    PubMed

    Zeng, Yingchun; Luo, Taizhen; Zhou, Ying

    2014-12-10

    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

  17. The underutilization of emergency contraception.

    PubMed

    Devine, Kit S

    2012-04-01

    Despite the availability of effective contraceptive methods, unintended pregnancy continues to be a significant health problem for women throughout the world. The reasons for unplanned pregnancy include failure to use contraception, incorrect use of contraception, unplanned consensual intercourse, and rape. Emergency contraception was once heralded as a means of reducing the rates of unintended pregnancy, elective abortion, and unwanted childbirth. But more than three decades after the first oral form was introduced, the use of emergency contraception remains suboptimal-even in the United States, where it is available to most women of childbearing age without a prescription. Nurses can help narrow this clinical gap in women's health care by increasing awareness of emergency contraception, correcting common misconceptions about its mechanism of action and potential adverse effects, and facilitating patient access. PMID:22421320

  18. 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…

  19. Natural contraception.

    PubMed

    Breuner, Cora Collette

    2005-10-01

    This article discusses some complementary and alternative medicine options for contraception, including natural family planning and plant-derived hormonal contraception. Primary care providers are crucial resources for advice and recommendations about these options. The discussion will include medical evidence to support or refute these methods, potential dangers of these interventions, and additional resources for those who want to learn more. PMID:16183542

  20. 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 ? 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

  1. Family planning dialogue. Rumors of contraception: myths vs facts.

    PubMed

    1990-01-01

    Noting Egypt's overpopulation problem, this publication addresses common misconceptions over the need for fertility regulation and rumors concerning contraceptives. Egypt's birth rate stands at 38/1000 population, and contraceptive prevalence among Egyptian couples is only 37%. Should current fertility levels continue, the country's population of 53 million will double in 23 years, and could reach 139 million by the year 2030. The publication explains that this trend threatens national development. Already, population growth has placed great strains on the food supply and on the availability of health and other social services, has diminished educational and employment opportunities, and has affected the distribution of income wealth. In order to confront this situation. Egypt established the National Population Council (NPC) in 1985. Some of its goals include lowering the birth rate to 28.5/1000 and increasing contraceptive prevalence to 51% by the year 2000. Part of NPC's strategy involves making population issues part of the educational curriculum, including the religious educational curriculum. Stressing the need to eliminate rumors concerning contraceptives, the publication gives the following general advice to physicians: 1) gain the patient's trust; 2) find out how the rumor got started and try to present the facts; and 3) let the patient meet other people who are satisfied with their contraceptive method. The publication also provides physicians specific advice on how to address rumors concerning the harmful side-effects of IUDs and oral contraceptives, how to deal with rumors concerning decreased sexual desire and sensation resulting from the use of IUDs and condoms, and what information to provide women who are interested in NORPLANT. PMID:12317021

  2. Emergency contraception.

    PubMed

    Lalitkumar, P G L; Berger, Cecilia; Gemzell-Danielsson, Kristina

    2013-02-01

    This review will focus on the available methods for emergency contraception (EC), efficacy, side effects and mechanisms of action. Copper intrauterine device (IUD) has been shown to be the most effective method for EC which can be continually used for regular contraception. However, this possibility is seldom used and may be little known. Among the hormonal EC methods 1.5 mg levonorgestrel is the most widely used EC pill while the more recently developed Ulipristal acetate (UPA) has been shown to be the most effective option. This is probably due to a more pronounced prevention of follicular rupture compared with other hormonal EC methods. Knowledge is needed to better advise lactating women and obese women on optimal EC method. Furthermore a possible interaction of UPA with regular hormonal contraception and possibilities for "bridging" from EC to regular contraception needs to be explored. To increase efficacy future studies should focus on EC methods that target the endometrium. PMID:23384749

  3. Oral Contraceptives

    Microsoft Academic Search

    Donna Shoupe; Daniel R. Mishell

    Because of social, political, financial, or legal reasons, many contraceptive methods have been removed from the contraceptive\\u000a armamentarium, sometimes almost as quickly as they were introduced. The original subdermal implant, a monthly intramuscular\\u000a injection containing medroxyprogesterone acetate and estradiol cypionate, and a multitude of intrauterine devices have all\\u000a been withdrawn from the US market after facing insurmountable problems. Over the

  4. 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

  5. Socio-economic and demographic factors affecting contraceptive use in Malawi.

    PubMed

    Palamuleni, Martin E

    2013-09-01

    Malawi has one of the highest Contraceptive Prevalence Rate (CPR) in Sub-Saharan Africa. However, fertility remains high and fertility decline is slow. This paper uses data from the 2000 and 2004 Demographic and Health Surveys to examine correlates of contraceptive use among currently married women in Malawi. Bivariate and multivariate logistic regression analyses were used to establish the relationships between socioeconomic variables and current use of contraception. The results show that the major determinants of contraceptive use are age, respondents' and partners' approval of family planning, family planning discussion with partner, number of living children, work status, education and visit to a health centre. As a policy measure, information, education and communication programmes on family planning should be intensified, particularly in rural areas and targeting men. PMID:24069771

  6. Community influences on contraceptive use in Mozambique.

    PubMed

    Cau, Boaventura Manuel

    2015-01-01

    Fertility in sub-Saharan Africa remains the highest in the world. Yet, the average contraceptive prevalence in Africa is the lowest in major world regions and there is limited understanding of the mechanisms through which community context shapes contraceptive use in the region. Using data from the 2011 Mozambique Demographic and Health Survey, we examine the mechanisms through which community context influences women's use of modern methods of contraception in Mozambique. We find that community context influences the use of modern methods of contraception by shaping the environment in which women live. PMID:25463912

  7. How Effective Is Male Contraception?

    MedlinePLUS

    ... health care providers to determine which method of birth control is best for them. For men, methods of ... sterilization procedures, is considered a permanent form of birth control. Different methods of contraception have different rates of ...

  8. 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

  9. Preventing Repeat Teen Pregnancy: Postpartum Depot Medroxyprogesterone Acetate, Oral Contraceptive Pills, or the Patch?

    Microsoft Academic Search

    Andrea Ries Thurman; Natalie Hammond; Helen E. Brown; Mary Ellen Roddy

    2007-01-01

    Study ObjectiveTo prospectively evaluate the repeat teen pregnancy rates, within one year of delivery, among adolescents who choose the contraceptive patch (Ortho Evra) versus oral contraceptive pills (OCP) versus Depot Medroxyprogesterone Acetate (Depo Provera, DMPA) for postpartum contraception.

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

    PubMed Central

    2014-01-01

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

  11. Emergency contraception.

    PubMed

    Li, Hang-Wun Raymond; Lo, Sue Seen Tsing; Ho, Pak-Chung

    2014-08-01

    This review summarises the development of emergency contraception (EC) methods, and provides an overview on the currently available options of EC which are effective and safe back-up methods in case of non-use or failure of the regular contraception. The copper intrauterine contraceptive device is currently the most effective method. In most countries, a single dose of levonorgestrel 1.5 mg is the first-line hormonal EC given within 72 h of unprotected intercourse. The oral anti-progestogens such as mifepristone and ulipristal acetate are promising alternatives with better efficacies and a wider treatment window of up to 120 h post coitus, probably resulting from more diverse ancillary mechanisms of actions. Education on EC should be part of any contraceptive counselling. Improving access to EC by providing it over the counter or in advance would not promote its abuse nor encourage risky sexual behaviours, but may further facilitate the timely use so as to achieve the best efficacy. PMID:24898437

  12. 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

  13. Emergency contraception: clinical outcomes.

    PubMed

    Glasier, Anna

    2013-03-01

    Emergency contraception (EC) is widely used to prevent unwanted pregnancy. This review considers the safety and efficacy of three commonly used methods -- levonorgestrel (LNG-EC), ulipristal acetate (UPA) and the copper intrauterine device. All are extremely safe, and side effects are minimal. Concerns about increased risks of ectopic pregnancy after EC use have proved unfounded, and possible teratogenic effects seem unlikely. Although the true effectiveness of EC is impossible to estimate, recent research suggests that LNG-EC prevents around 50% of expected pregnancies in women using the method within 72 h of intercourse, whereas UPA appeared to prevent almost two thirds of pregnancies. Emergency intrauterine device insertion probably prevents over 95% of pregnancies. However, although improved accessibility of EC has clearly led to increased use, it does not appear to have had any public health benefit in reducing unintended pregnancy rates. Most of the data on sexual behavior following improved access to EC do not show any detrimental effect on subsequent use of other more effective methods of contraception or on the incidence of unintended pregnancy or sexually transmitted infection. However, unless these other methods of contraception are also made easily available from pharmacies, improved access to EC risks unlinking its use with use of subsequent ongoing contraception. PMID:23040128

  14. 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

  15. 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 ...

  16. Obesity and contraception.

    PubMed

    Mody, Sheila K; Han, Michelle

    2014-09-01

    Utilizing contraception is critical in preventing unintended pregnancies among obese women. However, clinicians and obese patients may be unclear about which contraceptive methods are optimal. This review discusses the literature on any weight gain associated with contraceptive use, contraceptive efficacy among obese women, and special considerations for contraceptive method selection for women after bariatric surgery. The review also covers new findings on oral emergency contraception and obesity. PMID:25029338

  17. 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

  18. Prevalence and incidence rates of chronic inflammatory demyelinating polyneuropathy in the Japanese population

    Microsoft Academic Search

    M Iijima; H Koike; N Hattori; A Tamakoshi; M Katsuno; F Tanaka; M Yamamoto; K Arimura; G Sobue

    2008-01-01

    Objective and methods:To characterise the epidemiological features of chronic inflammatory demyelinating polyneuropathy (CIDP) in the Japanese population, this study performed a nationwide assessment of the prevalence and incidence rates in Japan.Results:The prevalence rate per 100 000 was 1.61 in the total population; 2.01 in males and 1.23 in females. The age dependent prevalence rates were 0.23 in juveniles (55 years).

  19. Reported prevalence of urinary incontinence in women in a general practice

    Microsoft Academic Search

    Jacqueline V Jolleys

    1988-01-01

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

  20. Oral contraception.

    PubMed

    Evans, Ginger; Sutton, Eliza L

    2015-05-01

    Oral contraception (OC) remains a popular noninvasive, readily reversible approach for pregnancy prevention and, largely off label, for control of acne, hirsutism, dysmenorrhea, irregular menstruation, menorrhagia, and other menstrual-related symptoms. Many OC formulations exist, with generics offering lower cost and comparable efficacy. Certain medical conditions, including hypertension, migraine, breast cancer, and risk of venous thromboembolism (VTE), present contraindications. Blood pressure measurement is the only physical examination or testing needed before prescription. Although no OC is clearly superior to others, OCs containing the second-generation progestin levonorgestrel have been associated with lower VTE risk than those containing other progestins. PMID:25841596

  1. 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

  2. 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…

  3. Non-oral contraception

    Microsoft Academic Search

    Kirsten I. Black; Ali Kubba

    2008-01-01

    Non-oral contraception is increasingly being promoted by contraceptive experts as a more convenient and, in many cases, safer and more efficacious alternative to oral contraception. Injectables, implants and intrauterine methods offer the advantage of being long-acting and less user dependent, factors which may potentially improve contraceptive compliance. Combined contraceptive methods in non-oral delivery forms offer a choice for women who

  4. Use of contraceptive methods among women treated for bipolar disorder.

    PubMed

    Magalhães, Pedro Vieira da Silva; Kapczinski, Flávio; Kauer-Sant'Anna, Marcia

    2009-06-01

    Contraception has been little investigated in bipolar disorder, an illness associated with impulsive sexual behavior and use of medications that are unsafe during pregnancy. In this cross-sectional survey of 136 women with bipolar disorder, prevalence of contraception use was 58.8%. Use of any method was associated in the multivariable analysis with being married, younger than 40 and having had previous pregnancies. Women diagnosed with bipolar disorder and treated in a tertiary facility use contraceptive methods suboptimally. PMID:19277844

  5. 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

  6. Prevalence of Abnormalities Influences Cytologists’ Error Rates in Screening for Cervical Cancer

    PubMed Central

    Evans, Karla K.; Tambouret, Rosemary H.; Evered, Andrew; Wilbur, David C.; Wolfe, Jeremy M.

    2014-01-01

    Context Medical screening tasks are often difficult, visual searches with low target prevalence (low rates of disease). Under laboratory conditions, when targets are rare, nonexpert searchers show decreases in false-positive results and increases in false-negative results compared with results when targets are common. This prevalence effect is not due to vigilance failures or target unfamiliarity. Objective To determine whether prevalence effects could be a source of elevated false-negative errors in medical experts. Design We studied 2 groups of cytologists involved in cervical cancer screening (Boston, Massachusetts, and South Wales, UK). Cytologists evaluated photomicrographs of cells at low (2% or 5%) or higher (50%) rates of abnormality prevalence. Two versions of the experiment were performed. The Boston, Massachusetts, group made decisions of normal or abnormal findings using a 4-point rating scale. Additionally, the group from South Wales localized apparent abnormalities. Results In both groups, there is evidence for prevalence effects. False-negative errors were 17% (higher prevalence), rising to 30% (low prevalence) in the Boston, Massachusetts, group. The error rate was 27% (higher prevalence), rising to 42% (low prevalence) in the South Wales group. (Comparisons between the 2 groups are not meaningful because the stimulus sets were different.) Conclusions These results provide the first evidence, to our knowledge, that experts are not immune to the effects of prevalence even with stimuli from their domain of expertise. Prevalence is a factor to consider in screening for disease by human observers and has significant implications for cytology-based cervical cancer screening in the post–human papillomavirus vaccine era, when prevalence rates of high-grade lesions in the population are expected to decline. PMID:22129183

  7. Adolescent use of the combined oral contraceptive pill: a retrospective observational study

    PubMed Central

    Krishnamoorthy, N; Ekins-Daukes, S; Simpson, C; Milne, R; Helms, P; McLay, J

    2005-01-01

    Aims: To determine the extent of combined oral contraceptive use by girls aged 10–16 years in Scotland. Methods: Assessment of combined oral contraceptive prescribing in 35 414 girls for the year 1 November 1999–31 October 2000 from data retrieved from 161 primary care practices taking part in the Scottish Programme for Improving Clinical Effectiveness in Primary Care, and from national aggregated data from family planning clinics. Results: During the study period the oral contraceptive pill (OCP) was prescribed by a primary care physician to 1531 girls (4.3%) aged 10–16 years. The age specific prevalence rates per 1000 girls registered with their family doctor rose from 0.9/1000 girls aged 12 years or younger, to 6.9, 30, 86.3, and 174.8/1000 for girls aged 13, 14, 15, and 16 years respectively. The overall prevalence of combined oral contraceptive prescribing by primary care physicians was 43.2/1000 girls aged 10–16 years. A further 1765 girls aged 13–16 years obtained a prescription for the OCP from a Scottish family planning clinic, giving an overall prevalence rate for family planning clinic prescribing of 8.0/1000 girls aged 10–16 years. Despite reportedly high levels of sexual activity and teenage pregnancy in this age group, these results confirm that OCP use is relatively low. Conclusions: The UK has the highest rate of teenage pregnancy in Western Europe, but despite the medical and social concerns about the sexual health of teenagers, the level of oral contraceptive use in this young age group remains low. PMID:15855181

  8. 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.

  9. 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

  10. Prevalence Rates of Attention Deficit/Hyperactivity Disorder in a School Sample of Venezuelan Children

    ERIC Educational Resources Information Center

    Montiel, Cecilia; Pena, Joaquin A.; Montiel-Barbero, Isabel; Polanczyk, Guilherme

    2008-01-01

    A total of 1,535 4-12 year-old children were screened with the Conners' rating scales, followed by diagnostic confirmation by the diagnostic interview schedule for children-IV-parent version. The prevalence of ADHD was estimated to be 10.03%, and only 3.9% of children had received medication for the treatment of ADHD symptoms. Prevalence rates and…

  11. Patterns of contraceptive use among urban women in Taiwan.

    PubMed

    Lethbridge, D J; Wang, R

    1991-01-01

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

  12. Copper Intrauterine Device for Emergency Contraception: Clinical Practice Among Contraceptive Providers

    PubMed Central

    Harper, Cynthia C.; Speidel, J. Joseph; Drey, Eleanor A.; Trussell, James; Blum, Maya; Darney, Philip D.

    2011-01-01

    Objective The copper intrauterine device (IUD) is the most effective emergency contraceptive available but is largely ignored in clinical practice. We examined clinicians’ recommendation of the copper IUD for emergency contraception in a setting with few cost obstacles. Methods We conducted a survey among clinicians (n=1,246; response rate 65%) in a California State family planning program, where U.S. Food and Drug Administration-approved contraceptives are available at no cost to low-income women. We used multivariable logistic regression to measure the association of intrauterine contraceptive training and evidence-based knowledge with having recommended the copper IUD for emergency contraception. Results The large majority of clinicians (85%) never recommended the copper IUD for emergency contraception, and most (93%) required two or more visits for an IUD insertion. Multivariable analyses showed insertion skills were associated with having recommended the copper IUD for emergency contraception, but the most significant factor was evidence-based knowledge of patient selection for IUD use. Clinicians who viewed a wide range of patients as IUD candidates were twice as likely to have recommended the copper IUD for emergency contraception. While over 93% of obstetrician–gynecologists were skilled in inserting the copper IUD, they were no more likely to have recommended it for emergency contraception than other physicians or advance practice clinicians. Conclusion Recommendation of the copper IUD for emergency contraception is rare, despite its high efficacy and long-lasting contraceptive benefits. Recommendation would require clinic flow and scheduling adjustments to allow same-day IUD insertions. Patient-centered and high-quality care for emergency contraception should include a discussion of the most effective method. PMID:22270272

  13. [Contraception in French teenage girls in 2007].

    PubMed

    Robin, G; Massart, P; Letombe, B

    2007-10-01

    The two main objectives of adolescence contraception are the eviction of involuntary pregnancies and the prevention of sexually transmitted infections. In France, in spite of our rich contraceptive arsenal and a widely spread information, the rate of voluntary termination of pregnancy keeps growing among the teenagers population--and this, probably because the gap between theoretical effectiveness and practice of contraception is particularly wide among the young people. Every contraceptive means can be used by teenagers; the best option being, it seems, the "double DUTCH", which consists of concomitant use of condoms and hormonal contraception. Most often, the consultation for contraception is the first gynaecological consultation. That is the reason why it is usually stressful for teenagers who dread undergoing a gynaecological examination. If this examination is not necessary for most of young patients, it is essential to create a trustful relationship and to make explicit the several contraceptive methods. During this consultation it is interesting to look for common teenage troubles like addiction to smoking and eating disorders. For any prescription of hormonal contraception, it is important to explain the benefits and the possible side effects, to stress the observance and to tell the teenager about the recommendations in case of forgetting. Concerning condom - the only efficient way of preventing sexually transmitted infections--, it is useful to talk about it in concrete and straightforward terms, to show its handling and to inform about risks of tearing. With this state of mind, an emergency contraception can be prescribed straightaway in order to make its use easier. Also, without any moralizing speech, the need for maturity must be emphasized as well as taking care of one's body with the aim of avoiding a premature pregnancy or any sexually transmitted infection. This consultation must be coupled with a close follow-up, availability and mutual confidence which are the main elements vouching for a good observance and consequently an efficient contraception. PMID:17855146

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

    PubMed

    Michie, L; Cameron, S T

    2013-06-01

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

  15. [Resistance and compliance to contraception in adolescents].

    PubMed

    Pichot, F; Dayan-lintzer, M

    1985-10-01

    Although inadequate information on sex and contraception is frequently believed to account for contraceptive failure in adolescents, other factors including resistence to contraception or poor compliance with method requirements have been invoked to explain contraceptive failures in well-informed adolescents. Sexual relations are beginning at ever-younger ages in France; a 1980 survey indicated that 50% had their 1st sexual relations before age 17. Sexual activity is sporadic and irregular but usually occurs with the same partner. At least 50% of 1st sexual relations are unprotected by contraception, and half of adolescent pregnancies occur in the 1st 6th months of sexual activity. 6-12 months pass on average before sexually active adolescents begin to use contraception. Rates of pregnancy and abortion have increased especially among adolescents under 16, and in 1979 almost 20% of all abortions were in women under 20 years old. In 1980, only 20% of adolescents used contraception, with 17.3% using oral contraceptives. Few statistics exist on the complex phenomenon of conscious or subconscious contraceptive resistence in adolescence, and clinical experience serves as a better guide. A frequent attitude among adolescents is that sexual relations should be spontaneous and romantic, traits viewed as incompatible with contraception. "Magical thinking", failure to appreciate the real risk of pregnancy, and dissociation of sex and pregnancy are common. Adolescents who doubt their fecundity may engage in unprotected relations to reassure themselves, while some seeking to assert their femininity may use pills although they have no need for contraception. Guilt and ambivalence may be unconscious motivations for poor contraceptive use. Young girls in cold, uncaring, neglectful, or conflict-ridden homes may seek affection from a sexual partner and wish to have a baby to demonstrate their attachment. Such situations often lead to well-accepted pregnancies and may also demonstrate a desire for self-affirmation, a search for identity, and a reliving of the mother's own childhood. Very young girls especially may be reluctant to discuss contraception for fear of displeasing their partners or losing their love. Fear of gynecological examinations, distrust of both the side effects of pills and the efficacy of all other contraceptive methods, and rebellion against the adult world are additional reasons for nonuse of contraception. Fears on the part of the mother or resentment of the daughter's maturity and sexuality or other feelings may impede communication and hence acquisition and use of contraception. Resistence by adults in general to expressions of sexuality among adolescents may prevent physicians from prescribing pills and educators from providing information on sex and contraception. Compliance with contraception appears to be a multidimensional phenomenon with 3 principal domaines: individual characteristics, the environment, and the availability of contraception. Unfavorable social situations and young age at initiation of sexual activity are unfavorable to compliance, while a well-defined identity, autonomy, and sense of responsability are favorable. The most important environmental factor is a supportive family, while the type of method appears to be less significant. Careful and sympathetic reception of the adolescent and good follow-up by the health worker can boost compliance. PMID:12267710

  16. Combined oral contraceptives: health benefits beyond contraception.

    PubMed

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

    2014-09-01

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

  17. Trends in male contraception.

    PubMed

    Pasqualotto, Fábio Firmbach; Lucon, Antônio Marmo; Pasqualotto, Eleonora Bedin; Arap, Sami

    2003-01-01

    Methods that are available for male contraception, namely coitus interruptus, condoms, and vasectomy, have been used since the 19th century. With the exceptions of a few improvements of these methods, no major progress has been made with respect to introducing new male contraceptives since then. It is extremely urgent to develop new, safe, effective, and reversible male contraceptive methods. Among all male contraceptive methods that are being investigated, the hormonal approach is the closest to clinical application. Hormonal contraception provides pregnancy protection by means of spermatogenic suppression. Androgen-progestin regimens currently represent the best available hormonal combination for induction of a profound suppression of spermatogenesis. Further development of new steroids is mandatory for increasing the choices of available contraceptive formulations and to optimize long-term safety of these regimens. PMID:14666325

  18. Access to emergency contraception

    Microsoft Academic Search

    James Trussell; Vanessa Duran; Tara Shochet; Kirsten Moore

    2000-01-01

    Objective: To evaluate access to emergency contraception among women seeking help from clinicians who registered to be listed on the Emergency Contraception Hotline (1-888-NOT-2-LATE, ie, 1-888-668-2528) and the Emergency Contraception Website (not-2-late.com).Methods: Two college-educated investigators posing as women who had a condom break the previous night called 200 providers to seek help.Results: Only 76% of attempts resulted in an appointment

  19. Update on emergency contraception

    Microsoft Academic Search

    Paul M. Fine

    2011-01-01

    Emergency contraception is a woman’s last chance to prevent unintended pregnancy. Ulipristal acetate, a selective progesterone\\u000a receptor modulator, when taken as a single 30 mg dose, is a new, safe and effective emergency contraceptive that can be used\\u000a from the first day and up to 5 days following unprotected intercourse. The older progesterone-only emergency contraceptive,\\u000a levonorgestrel, is taken as two

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

    Microsoft Academic Search

    M Hagberg; D H Wegman

    1987-01-01

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

  1. 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…

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

    Microsoft Academic Search

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

    1999-01-01

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

  3. Contraception for adolescents.

    PubMed

    French, Rebecca S; Cowan, Frances M

    2009-04-01

    Ensuring that sexually active adolescents are using contraception consistently and correctly is an effective means of reducing unplanned pregnancy. Use of highly effective long-acting reversible methods, such as subdermal implants, is low. We need to challenge the perception that the pill and condoms, the most commonly used contraceptive methods, are always the most suitable methods for young people. Changes in adolescent sexual behaviour, including increased number of sexual partners, is consistent with a rise in sexually transmitted infections. No contraceptive methods, with the exception of male or female sterilisation, are contra-indicated solely on the grounds of age. Young people need to be counselled about both the benefits and risks associated with each method so that they can make an informed choice. Most of the clinical evidence on contraceptive use comes from studies of 'older' women, with little research identified that specifically addressed implications for adolescent contraceptive use. PMID:19171502

  4. Recent advances in hormonal contraception.

    PubMed

    Li, Hw Raymond; Anderson, Richard A

    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

  5. 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

  6. Efficacy of different contraceptive methods.

    PubMed

    Vessey, M; Lawless, M; Yeates, D

    1982-04-10

    The Oxford Family Planning Association (Oxford, England) contraceptive study has yielded data on the efficacy of a wide range of birth control methods for a large, homogeneous group of married women attending family planning clinics. Some of the main findings are summarized in the hope that they may be of direct value to the practicing physician. 17,032 women were recruited from 17 large family planning clinics in England and Scotland during 1968-1974. At recruitment, every woman was aged 25-39 years, married, a white British subject, willing to participate, and either a current user of oral contraceptives (OCs) of at least 5 months' standing or a current user of a diaphragm or an IUD of at least 5 months' standing without prior exposure to the pill. On return visits to the clinic, each woman is questioned and data, including details of all pregnancies and any change in contraceptive practice together with reasons for the change, are recorded on a special form. In the analyses which follow, the failure rates represent "use-effectiveness," i.e., they include accidental pregnancies attributable both to failure of the method and to failure by the woman to use the method correctly. Overall failure rates for the different contraceptive methods together with 95% confidence limits are shown in a table. The failure rate/100 woman-years is as follows: for combined OCs with more than 50 mcg estrogen--0.32, with 50 mcg estrogen--0.16, and with less than 50 mcg estrogen--0.27; progestogen-only OC, 1.2; diaphragm, 1.9; condom, 3.6; Lippes loop A 6.8; Lippes loop B, 1.8; Lippes loop C, 1.4; Lippes loop D, 1.3; Saf-T-Coil, 1.3; Dalkon shield, 2.4; Birnberg bow, 1.6; Antigon, 0.4; M-213, 1.3; Copper-T, 1.2; Copper-7, 1.5; Multiload, 0.0; type unknown, 1.8; rhythm, 15.5; coitus interruptus, 6.7; chemicals alone, 11.9; female sterilization, 0.13; and male sterilization, 0.02. Sustained motivation is essential for effective use of contraceptive methods requiring deliberate action on the part of the user. Accordingly, the failure rates were analyzed for OC users, diaphragm and condom users in relation to the only direct indicator of motivation recorded in the study, i.e., whether or not a woman considered her family to be complete. A substantial effect was apparent only for diaphragm users. PMID:6122067

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

    Microsoft Academic Search

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

    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

  8. 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…

  9. Contraception matters: indicators of poor usage of contraception in sexually active women attending family planning clinics in Victoria, Australia

    PubMed Central

    2012-01-01

    Background Unintended pregnancy (mistimed or unwanted) remains an important health issue for women. The purpose of this study was to determine the prevalence of and factors associated with risk of unintended pregnancy in a sample of Victorian women attending family planning clinics. Methods This cross-sectional survey of three Family Planning Victoria Clinics from April to July 2011 recruited women aged 16-50 years with a male sexual partner in the last 3 months, and not intending to conceive. The questionnaire asked about contraceptive behaviours and important factors that influence contraception use (identified from a systematic literature review). Univariate analysis was calculated for the variables of interest for associations with contraceptive use. An overall multivariate model for being at risk for unintended pregnancy (due to inconsistent or ineffective contraceptive use or non-use) was calculated through backward elimination with statistical significance set at <0.05. Results 1006 surveys were analyzed with 96% of women reporting contraception use in the last 3 months. 37% of women were at risk for unintended pregnancy due to imperfect use (61% inconsistent users; 31% ineffective methods) or never using contraception (8%). On multivariate analysis, women at risk for unintended pregnancy compared with women not at risk were <25 years old (OR 1.8, 95% CI 1.2-2.7); had no university/postgraduate degree (OR 1.7, 95% CI 1.2-2.4); and had >1 partner in the last 3 months (OR 3.2, 95% CI 2.3-4.6). These women were dissatisfied with current contraception (OR 2.5, 95% 1.8-3.5); felt “vulnerable” to pregnancy (OR 2.1, 95% CI 1.6-3.0); were not confident in contraceptive knowledge (OR 2.6, 95% CI 1.5-4.8); were unable to stop to use contraception when aroused (OR 2.1, 95% CI 1.5-2.9) but were comfortable in speaking to a doctor about contraception (OR 2.3, 95% CI 1.1-4.1). Conclusion Despite reported high contraceptive usage, nearly 40% of women were at risk for unintended pregnancy primarily due to inconsistent contraceptive use and use of ineffective contraception. Strategies for improving consistency of effective contraception use or greater emphasis on long-acting contraception may be needed for certain subpopulations at higher risk for unintended pregnancy. PMID:23259407

  10. Patterns of Contraceptive Use Within Teenagers’ First Sexual Relationships

    PubMed Central

    Manlove, Jennifer; Ryan, Suzanne; Franzetta, Kerry

    2006-01-01

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

  11. Adolescent Contraception: An Overview

    PubMed Central

    Pavilanis, Alan V.

    1988-01-01

    Adolescents are sexual beings who are undergoing important biological and social changes. Physicians must recognize the need for contraception in their teenage patients and realize when teenagers are asking for contraception. In order to deal effectively with the question of birth control, the physician must be comfortable with the issues of adolescent development and sexuality, as well as with his of her own sexuality. The birth-control pill remains the contraceptive prescription of choice, but other methods of birth control are discussed as well. Physicians must also be prepared to validate a teenager's decision not to engage in intercourse. PMID:21253171

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

    Microsoft Academic Search

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

    2007-01-01

    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

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

    PubMed Central

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

    2014-01-01

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

  14. Widely varying SIV prevalence rates in naturally infected primate species from Cameroon.

    PubMed

    Aghokeng, Avelin F; Liu, Weimin; Bibollet-Ruche, Frederic; Loul, Severin; Mpoudi-Ngole, Eitel; Laurent, Christian; Mwenda, Jason M; Langat, Daudi K; Chege, Gerald K; McClure, Harold M; Delaporte, Eric; Shaw, George M; Hahn, Beatrice H; Peeters, Martine

    2006-02-01

    Although it is now well established that a substantial proportion of wild-living primates in sub-Saharan Africa harbor SIV, no study to date has examined to what extent the various species are naturally infected. In this study, we first describe the development and validation of sensitive and specific SIV antibody detection assays representing all major known primate lentiviral lineages on a panel of 207 sera from 11 different primate species with known infection status. The newly developed assays were then used to determine SIV prevalence rates in nine primate species native to Cameroon. Analysis of 722 sera revealed widely varying prevalence rates, ranging from an apparent absence of SIV infection in crested mona (0/70), grey cheeked (0/36) and agile mangabeys (0/92), to prevalence rates of 3%, 4%, 11%, 27%, 39% and 52% for mustached (6/203), greater spot-nosed (8/193), northern talapoin (3/26), mantled guereza (14/52), De Brazza's (9/23) and mandrill (14/27) monkeys, respectively. The epidemiology of naturally occurring SIV infections is thus more complex than previously appreciated and the various non-human primate hosts seem to differ in their susceptibility to SIV infection. The newly developed assays should now permit to define with greater accuracy existing SIV reservoirs and associated human zoonotic risk. PMID:16257029

  15. 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?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

  16. 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

  17. Factors associated with the differences in migraine prevalence rates between Spanish regions.

    PubMed

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

    2014-01-01

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

  18. Protrhombotic effects of contraceptives.

    PubMed

    Fazio, Giovanni; Ferrara, Filippo; Barbaro, Giuseppe; Alessandro, Gullotti; Ferrro, Giovanni; Novo, Giuseppina; Novo, Salvatore

    2010-01-01

    The use of oral contraceptives first became widespread some 40 years ago, and reports of an excess risk of cardiovascular disease among women who used these agents soon followed. Few drugs have been the object of such intensive epidemiological research, the outcome of which has provided clinicians with detailed information about risks not only of specific thrombotic diseases but also important non-contraceptive benefits from the pill. Recently, oral contraceptives have been classified by some according to "generation" (first, second, third, and most recently, fourth generation): first-generation formulations containing lynestrenol or norethindrone, second-generation formulations containing levonorgestrel, third-generation formulations containing desogestrel or gestodene, and oral contraceptives containing an estrogen and other progestagens (cyproterone or norgestimate) or a progestagen alone. The results of several study was that the use of the older high-dose oral contraceptives increased the risk of cardiovascular disease by modifying the Low-density lipoprotein and High-Density lipoprotein cholesterol level, increasing triglyceride serum level, reducing glucose tolerance, raising blood pressure, and promoting clotting mechanisms. In this review we investigate the mechanism of the oral contraceptives and performed a risk assessment of every generation. PMID:20858187

  19. Male contraception: history and development.

    PubMed

    Kogan, Paul; Wald, Moshe

    2014-02-01

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

  20. Contraceptive needs of the adolescent.

    PubMed

    Steyn, Petrus S; Goldstuck, Norman D

    2014-08-01

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

  1. Stroke in women - oral contraception, pregnancy, and hormone replacement therapy.

    PubMed

    Rantanen, Kirsi; Tatlisumak, Turgut

    2013-01-01

    Stroke is a devastating disease affecting millions of people worldwide every year. Female stroke victims have higher mortality rates and they do not re-cover as well as men. Women's longevity and different vascular risk factor burden like a larger prevalence of atrial fibrillation play a role. Women also have unique risk factors such as oral contraception, pregnancy, estrogen decrease after the menopause and hormone replacement therapy, which should all be evaluated and taken into consideration in treatment decisions both in the acute phase of stroke and in secondary prevention. In this review, the evidence regarding these hormonal aspects and the risk of stroke in women are evaluated. The relevant guidelines are studied and research gaps identified. Future topics for research are recommended and current treatment possibilities and their risks discussed. PMID:22724472

  2. Disturbances of motor unit rate modulation are prevalent in muscles of spastic-paretic stroke survivors

    PubMed Central

    Heckman, C. J.; Powers, R. K.; Rymer, W. Z.; Suresh, N. L.

    2014-01-01

    Stroke survivors often exhibit abnormally low motor unit firing rates during voluntary muscle activation. Our purpose was to assess the prevalence of saturation in motor unit firing rates in the spastic-paretic biceps brachii muscle of stroke survivors. To achieve this objective, we recorded the incidence and duration of impaired lower- and higher-threshold motor unit firing rate modulation in spastic-paretic, contralateral, and healthy control muscle during increases in isometric force generated by the elbow flexor muscles. Impaired firing was considered to have occurred when firing rate became constant (i.e., saturated), despite increasing force. The duration of impaired firing rate modulation in the lower-threshold unit was longer for spastic-paretic (3.9 ± 2.2 s) than for contralateral (1.4 ± 0.9 s; P < 0.001) and control (1.1 ± 1.0 s; P = 0.005) muscles. The duration of impaired firing rate modulation in the higher-threshold unit was also longer for the spastic-paretic (1.7 ± 1.6 s) than contralateral (0.3 ± 0.3 s; P = 0.007) and control (0.1 ± 0.2 s; P = 0.009) muscles. This impaired firing rate of the lower-threshold unit arose, despite an increase in the overall descending command, as shown by the recruitment of the higher-threshold unit during the time that the lower-threshold unit was saturating, and by the continuous increase in averages of the rectified EMG of the biceps brachii muscle throughout the rising phase of the contraction. These results suggest that impairments in firing rate modulation are prevalent in motor units of spastic-paretic muscle, even when the overall descending command to the muscle is increasing. PMID:24572092

  3. 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

  4. 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…

  5. Recasting image of contraceptives.

    PubMed

    Rimon Jg; Kiragu, K

    1993-03-01

    Even though contraceptives are linked to sex which, along with sensuality and peer acceptance, is used to market consumer goods, contraceptives are promoted in a hygienic, clinical way. Glamorous images which divert from adverse health effects are used to sell unhealthy goods, e.g., alcohol and cigarettes, but technical and intimidating promotion techniques centering on risks are used to promote family planning (FP) products and services which actually save the lives of mothers and children and improve their health. Until recently, only the medical system provided FP products and services so consumers identified them with illness and a help-seeking behavior. The image of contraceptives must be remolded to gain people's attention. To avoid instilling mistrust of a method in consumers, even those who believe in birth spacing, it is important for images to be positive and to reflect accurate information. In Indonesia, the Dualima condom has been linked to responsible fatherhood thereby creating a positive image and removing the negative image of a condom being linked to illicit sex. In the US, condom adds show the user in control, especially in reference to AIDS. Prior to promotion of any contraceptive, complete, clear communication and marketing plans are needed to identify and to focus on consumers' perceived needs. A survey in Egypt shows that the most important attributes of a contraceptive are ease of use, healthiness, and effectiveness and that Egyptians considered IUDs to best fit these attributes. Images of contraceptive users often determine whether potential users do choose to use contraceptives. For example, in Cameroon and the Philippines, female users are considered to be smart, rich, educated, confident and in control of their lives. In the Philippines, male users are perceived to be loving, caring, and considerate husbands. The mass medias can improve providers' public image as was the case in Turkey and Egypt. PMID:12318099

  6. Contraceptive Steroids, age, and the cardiovascular system.

    PubMed

    Plunkett, E R

    1982-03-15

    There is evidence that women who use oral contraceptives may be at slightly greater risk of cardiovascular complications as their age increased beyond 35 years. Popular opinion has held that these risks were largely estrogen-related. At the same time, however, postmenopausal women taking natural estrogen alone or in association with minimal amounts of progestogen have not exhibited these increased risk when compared with untreated control subjects. New clinical data indicate that there is a progestogen dose-related decrease in high-density lipoprotein cholesterol. There is also some evidence that relates progestogen dosage to morbidity rates from circulatory disease. Therefore the smallest dose of both estrogen and progestogen consistent with contraceptive efficacy and reasonable cycle control must be sought for all steroid combinations. This applies particularly to oral contraception for the woman beyond 35 years of age. PMID:7065055

  7. 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

  8. Oral Contraceptive Pill and PCOS

    MedlinePLUS

    ... PCOS is healthy nutrition, exercise, and medications. Adolescent girls and young women are frequently prescribed oral contraceptive ... endometriosis. Oral contraceptive pills lower hormone levels in girls with PCOS and regulate their menstrual periods. Hormone ...

  9. An update on emergency contraception.

    PubMed

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

    2014-04-01

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

  10. A Short History of Contraception

    ERIC Educational Resources Information Center

    Lieberman, Janet J.

    1973-01-01

    Outlines the history of contraception, tracing the development of contraceptive methods from those used in primitive societies to the most recent techniques made available by medical science. Also describes the activities of the pioneers who have popularized birth control. (JR)

  11. Contraceptive use in Flanders (Belgium): A comparison between a general population sample and a Turkish ethnic minority sample.

    PubMed

    Elaut, Els; Buysse, Ann; Caen, Maya; Vandamme, Joke; Vermeire, Katrien; T'Sjoen, Guy

    2015-08-01

    Objectives To identify contraceptive profiles, and factors affecting these, among women of childbearing age, living in Flanders. Methods The prevalence of knowledge and use of the emergency contraceptive pill (ECP) and contraceptive use is assessed in two samples from the SEXPERT-survey 'Sexual health in Flanders': (i) a population-based sample (n = 724); and (ii) a probability sample of respondents of Turkish descent (n = 216). Results Knowledge, but not use, of the ECP is significantly lower among women from the ethnic minority sample, even after correction for income and educational background. A lower educational level is associated with less knowledge of the ECP in both samples. In the general population sample, 16% of sexually active women of childbearing age are at risk of an unplanned pregnancy, compared to 14% of their peers of Turkish origin. These rates are comparable, even after controlling for the different socio-economic status (income and educational level) in both samples. Conclusions Contraceptive profiles of sexually active women of Turkish descent residing in Flanders are mostly similar to those of their counterparts in the general population. Further research is required to develop strategies to improve ECP-knowledge among women with lower educational achievements. PMID:25712536

  12. Intrauterine devices and other forms of contraception: thinking outside the pack.

    PubMed

    Allen, Caitlin; Kolehmainen, Christine

    2015-05-01

    A variety of contraception options are available in addition to traditional combined oral contraceptive pills. Newer long-acting reversible contraceptive (LARC) methods such as intrauterine devices and subcutaneous implants are preferred because they do not depend on patient compliance. They are highly effective and appropriate for most women. Female and male sterilization are other effective but they are irreversible and require counseling to minimize regret. The contraceptive injection, patch, and ring do not require daily administration, but their typical efficacy rates are lower than LARC methods and similar to those for combined oral contraceptive pills. PMID:25841597

  13. 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

  14. Recent advances in contraception.

    PubMed

    Aiken, Abigail R A; 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

  15. 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

  16. Increased Prevalence of Reduced Estimated Glomerular Filtration Rate in Chronic Hepatitis C Patients

    Microsoft Academic Search

    Sorin A. Petre; Mankanwal S. Sachdev; Brie N. Noble; Marianne Rosati; Marek J. Mazur; Raymond L. Heilman; M. Edwyn Harrison; David D. Douglas; Vijayan Balan

    2010-01-01

    Background  To investigate the prevalence and severity of reduced estimated glomerular filtration rate (eGFR) in patients with chronic\\u000a hepatitis C (CHC).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Medical record review of 831 consecutive CHC patients seen in our clinic between July 2000 and August 2003; eGFR was estimated\\u000a using the abbreviated Modification of Diet in Renal Disease (aMDRD) equation. The stage of kidney disease was determined based

  17. The role of emergency contraception

    Microsoft Academic Search

    James Trussell; Charlotte Ellertson; Felicia Stewart; Elizabeth G Raymond; Tara Shochet

    2004-01-01

    Emergency contraception is an underused therapeutic option for women in the event of unprotected sexual intercourse. Available postcoital contraceptives include emergency contraceptive pills (ECPs) both with and without estrogen, and copper-bearing intrauterine devices. Each method has its individual efficacy, safety, and side effect profile. Most patients will experience prevention of pregnancy, providing they follow the treatment regimen carefully. There are

  18. Emergency Contraception: A Brief Review

    Microsoft Academic Search

    Amy Olin-Jenkinson; Carolyn Sachs

    The authors review the history leading up the development of post coital contraception. The authors focus on later forms of post-coital contraception, reviewing mechanism of action, dosage and timing, safety, efficacy, and repeated use. Social issues, including barriers to access, and cultural beliefs regarding abortion and emergency contraception are addressed.

  19. Adolescent Religiosity and Contraceptive Usage.

    ERIC Educational Resources Information Center

    Studer, Marlena; Thornton, Arland

    1987-01-01

    Examined contraceptive use by never married, sexually experienced female adolescents (N=224). Found birth control pills to be the single most popular method of contraception. Subjects who reported regularly attending religious services were less likely to have used an effective, medical method of contraception than those who rarely attended…

  20. Updates in hormonal emergency contraception.

    PubMed

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

    2011-09-01

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

  1. Sexuality: sexual activity and contraception during adolescence.

    PubMed

    Creatsas, G K

    1993-12-01

    Adolescent sexual activity is increasing. Premature sexual intercourse results in high figures of adolescent pregnancy and abortion, as well as in increased risk of sexually transmitted diseases (STDs). Lack of information on the prevention of STDs and poor hygiene in both boys and girls are also main reasons for increased morbidity because of STDs during adolescence. Contraceptive behaviour during adolescence varies between countries and communities. It seems, however, that the condom and oral contraceptives (OC) are popular contraceptive methods. Ineffective methods such as periodic abstinence, coitus interruptus, and withdrawal before ejaculation are in use. On the other hand, compliance of adolescents on contraception is poor. The above are additional causes for increasing rates of adolescent pregnancies. Countries providing sexual education programs in schools present lower rates of pregnancy and abortion. Adolescent pregnancy is safe if a careful follow up is accepted by the teenager. A significant number of homeless youth are homosexuals or lesbian adolescents. Most of them are at high risk for HIV infection, AIDS, and STDs. It is concluded that sexual education programs are absolutely necessary to offer adolescents the knowledge on the complications of premature sexual activity, as well as prevention of the undesired pregnancy and STDs. PMID:8286689

  2. Update on emergency contraception.

    PubMed

    Fine, Paul M

    2011-02-01

    Emergency contraception is a woman's last chance to prevent unintended pregnancy. Ulipristal acetate, a selective progesterone receptor modulator, when taken as a single 30 mg dose, is a new, safe and effective emergency contraceptive that can be used from the first day and up to 5 days following unprotected intercourse. The older progesterone-only emergency contraceptive, levonorgestrel, is taken as two 0.75 mg pills 12 hours apart (Next Choice(®); Watson Pharmaceuticals Inc., Morristown, NJ, USA) or a single 1.5 mg pill (Plan B One-Step™; Watson Pharmaceuticals Inc.), and is approved for only 72 hours after unprotected intercourse. During clinical development, ulipristal acetate has been shown to be more effective than levonorgestrel in delaying or inhibiting ovulation. A recent meta-analysis of two randomized clinical trials showed ulipristal acetate to have a pregnancy risk 42% lower than levonorgestrel up to 72 hours and 65% lower in the first 24 hours following unprotected intercourse. Moreover, when taken beyond 72 hours, significantly more pregnancies were prevented with ulipristal acetate than with levonorgestrel. Side effects are mild and similar to those seen with levonorgestrel. Ulipristal acetate was approved for emergency contraception by the US Food and Drug Administration in August 2010, and has been launched in the USA as ella(®) (Watson Pharmaceuticals Inc.) since December 1, 2010. Ella is prescription only and is priced comparable to Plan B One-Step. PMID:21153722

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

    PubMed Central

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

    2014-01-01

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

  4. 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

  5. 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

  6. Warning about contraceptive device given.

    PubMed

    Mayor, S

    1998-01-17

    The British Department of Health has issued a warning that the contraceptive device Persona may be an unreliable method of fertility control. This method tests hormone levels in urine to enable women to avoid unprotected intercourse during the fertile phase of the menstrual cycle. A pre-marketing clinical trial conducted by Upipath, the manufacturer of Persona, claimed a 94% reliability rate. However, the Medical Devices Agency has been unable to substantiate this claim and received numerous complaints from users, general practitioners, and trading standards officers. The warning letter advises physicians that, although Persona is basically a test-based form of the rhythm method, its technological basis may raise user expectations of accuracy. The letter notes that users should be aware a 94% reliability may also be expressed as a risk of 1 in 17 users becoming pregnant per 12 months of use. Persona is not considered suitable for women whose menstrual cycles do not fall into the 23-35 day range, those who have recently given birth or are breast feeding, and users of hormonal contraception. PMID:9468673

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

    Microsoft Academic Search

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

    2010-01-01

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

  8. 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

  9. Childhood leprosy--study of prevalence rates and clinical aspects through surveys in Bombay.

    PubMed

    Ganapati, R; Naik, S S; Pandya, S S

    1976-10-01

    This paper summarises the experience gained through extensive surveys of school children carried out in Greater Bombay over the past five years. The strikingly high proportion of children of 6 to 14 years age group suffering from leprosy attending the Acworth Leprosy Hospital and its peripheral clinic prompted these surveys. While surveys of 10% of child population attending randomly selected municipal schools revealed a general prevalence rate of 3 per 1000, there existed pockets of endemicity of the order of 10.8 per 1000, in some schools situated in the northern suburbs of the city. Even private schools catering to the not-so-poor sections of the community showed prevalence rates of over 6 per 1000, confirming the hyperendemicity of leprosy in Bombay city, with no socioeconomic or age group immune from exposure. Clinical observations of 1265 leprosy cases identified in the course of the above surveys covering a total population of nearly 1.8 lakhs of school children are presented. 24.7% of the cases had either the potential to develop into progressive forms of leprosy in view of the multiplicity of lesions or were already in an advanced stage of the disease. Polyneuritic leprosy together with intermediate and lepromatous types representing 5.8% of all cases (24 cases were confirmed to be smear positive) belonged to the groups posing therapeutic as well as public health problems. Analysis of 953 cases with single lesions revealed greater frequency of distribution (58.4%) of patches in parts of the body which are generally covered. It is striking that 26.4% of the solitary lesions was found in the gluteal regions and thighs, emphasising the need for thorough examinations of these parts during surveys. PMID:1026800

  10. Menstrual Bleeding Patterns Following Levonorgestrel Emergency Contraception

    E-print Network

    Paris-Sud XI, Université de

    Menstrual Bleeding Patterns Following Levonorgestrel Emergency Contraception Erin Gainer1 Organization have established levonorgestrel as the gold standard in hormonal emergency contraception (EC proportion of users. Key words Levonorgestrel, emergency contraception, morning after pill, bleeding

  11. 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

  12. Metabolic effects of contraceptive steroids

    Microsoft Academic Search

    Regine Sitruk-Ware; Anita Nath

    2011-01-01

    Estrogen and progestins have been used by millions of women as effective combined contraceptives. The safety of hormonal contraceptives\\u000a has been documented by years of follow-up and serious adverse events that may be related to their use are rare in the young\\u000a population exposed to these agents. The balance between the benefits and the risks of contraceptive steroids is generally

  13. Update on emergency contraception.

    PubMed

    Murphy, Patricia Aikins

    2012-01-01

    Emergency contraception (EC) is any method used after sexual intercourse to prevent pregnancy. This article provides an overview of the history of EC methods and describes the current availability of oral and intrauterine EC. Oral forms include the Yuzpe regimen (combining ethinyl estradiol and levonorgestrel), levonorgestrel-only pills, and ulipristal acetate, which is a new emergency contraceptive drug recently approved by the US Food and Drug Administration. The copper T-380A intrauterine device can also be used for EC. Information about dosing, timing, access, and other considerations in the provision of EC is covered. Clinicians should be aware of all available options in order to counsel women in need of EC appropriately. PMID:23050729

  14. 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

  15. Ulipristal. Postcoital contraception: no better than levonorgestrel.

    PubMed

    2010-04-01

    Postcoital contraception, also known as emergency contraception, is currently based on a single 1.5 mg dose of levonorgestrel, a progestin, taken within 3 days after unprotected intercourse. However, efficacy appears to be similar when the drug is taken within 4 or 5 days. Ulipristal, a progesterone receptor agonist-antagonist, is now authorised in the European Union for postcoital contraception within 5 days after unprotected intercourse. Clinical evaluation of ulipristal in this setting is based on two trials versus levonorgestreland one non-comparative trial. One double-blind trial in 1672 women failed to show that ulipristal, taken within 3 days following intercourse, was any more effective than levonorgestrel. In another trial including 1893 women, ulipristal was not statistically more effective than levonorgestrel when the two drugs were taken within 5 days after intercourse. In a non-comparative trial in 1533 women who took ulipristalon the third, fourth or fifth day after intercourse, the pregnancy rate was 2.1%. This is lower than would be expected without contraception (about 5.5%) but an indirect comparison, providing only a low level of evidence, did not show superiority over levonorgestrel. Ulipristal, like levonorgestrel, can cause nausea and vomiting, and menstrual disorders. A few cases of ovarian cysts were observed with ulipristal, two of which required surgery. Co-administration of enzyme inducers may reduce the efficacy of both ulipristal and levonorgestrel. Little information is available on the risks incurred by the mother or child when ulipristal fails to terminate a pregnancy. As ulipristal has no proven advantages, postcoital contraception should continue to be based on levonorgestrel, a better-assessed drug. Levonorgestrel can be used up to 5 days after unprotected intercourse, even though it is only approved for use during the first 3 days. PMID:20568481

  16. 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 (?2?=?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 (?2?=?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

  17. 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

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

    Microsoft Academic Search

    Joseph R. Hibbeln

    2002-01-01

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

  19. 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…

  20. 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

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

    PubMed Central

    Çagl?, Bekir; Tekata?, Aslan; K?r?c?, Mehmet Yadigar; Ünlü, Ercüment; Gençhellaç, 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

  2. Conscientious Objection and Emergency Contraception

    Microsoft Academic Search

    Robert F. Card

    2007-01-01

    This article argues that practitioners have a professional ethical obligation to dispense emergency contraception, even given conscientious objection to this treatment. This recent controversy affects all medical professionals, including physicians as well as pharmacists. This article begins by analyzing the option of referring the patient to another willing provider. Objecting professionals may conscientiously refuse because they consider emergency contraception to

  3. Contraception and sexually transmitted infections

    Microsoft Academic Search

    Judith Stephenson

    2005-01-01

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

  4. A decade of change in contraceptive behaviour in Latin America: a multivariate decomposition analysis.

    PubMed

    Castro Martin, T; Njogu, W

    1994-01-01

    This study relies heavily on World Fertility Survey and Demographic and Health Surveys data to examine recent trends and determinants of contraceptive use in five Latin American countries: Colombia, Dominican Republic, Ecuador, Mexico, and Peru. These countries experienced a substantial increase in contraceptive prevalence in the inter-survey period. Within countries, however, the increase was not equally shared by all social and demographic groups. The study found that relatively disadvantaged groups experienced greater gains in contraceptive use. Despite the prevailing tendency towards convergence, wide differentials in contraceptive behavior among social sectors still persist. A decomposition analysis based on logistic regression revealed that certain shifts in the population composition--i.e., increased proportion of urban and better educated women and a growing proportion of mothers who want to discontinue child-bearing--contributed substantially to the aggregate increase in contraceptive prevalence in most countries. Structural changes, understood as changes in the relations between the explanatory variables and the likelihood of using contraception, were also found to play a significant role in contraceptive use trends, particularly in Colombia. PMID:12345760

  5. A Qualitative Analysis of Long-Acting Reversible Contraception.

    PubMed

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

    2015-07-01

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

  6. Adolescent pregnancy and contraception.

    PubMed

    Dalby, Jessica; Hayon, Ronni; Carlson, Jensena

    2014-09-01

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

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

    PubMed

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

    2008-11-01

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

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

    Microsoft Academic Search

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

    1999-01-01

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

  9. Prevalence rate for inherited thrombophilia in patients with chronic and recurrent venous leg ulceration.

    PubMed

    Wiszniewski, Adam; Bykowska, Ksenia; Bilski, Radoslaw; Ja?kowiak, Wojciech; Proniewski, Jacek

    2011-01-01

    The aim of the study was to determine the prevalence rate for inherited thrombophilia (IT) in patients with chronic (CVU) and recurrent venous leg ulceration. We also investigated and evaluated the severity of the clinical pattern of CVU in patients with and without IT. We examined 110 patients with CVU (the study group) and 110 healthy subjects (the control group). We prepared a questionnaire to be completed by each study participant. Ultrasound Doppler color imaging or/and duplex ultrasonography was performed to evaluate the efficiency of the venous system. The ankle-brachial index was calculated to determine the efficiency of the arterial system. We examined both groups for the presence of IT. IT was diagnosed in 30% of study group and in 1.8% of control group. Our diagnoses of deep vein thrombosis (DVT) were based on medical interviews, physical examinations, and an ultrasonography of the venous system and concerned 64 study group patients (58.2%), 35 of whom (31.8%) experienced recurrent DVT. Proximal and/or distal DVT was determined in an interview and/or by an ultrasonography performed for all patients with CVU and IT. In 94% of these patients, DVT was recurrent, and in 88% of patients with CVU and IT, we observed recurrent DVT and CVU. It recurred more often and persisted longer when compared to patients with CVU and no IT, despite similar management. No differences were observed in ulcer size, localization, or pain level related to ulceration between patients with CVU and IT and those with CVU and no IT. PMID:22092793

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

    PubMed Central

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

    2014-01-01

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

  11. 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

  12. The Developing Role of Pharmacists in Patient Access to Emergency Contraception

    Microsoft Academic Search

    Judith A. Soon; Marc Levine; Mary H. H. Ensom; Jacqueline S. Gardner; Hilary M. Edmondson; David W. Fielding

    2002-01-01

    Unintended pregnancy and subsequent abortion remain major public health issues in many countries, despite evidence that post-coital emergency contraceptives have a good safety profile, are easy to use, and are effective in preventing unwanted pregnancies. Although emergency contraceptives have been prescribed in developed countries for more than 25 years, abortion rates have continued to rise steadily in many jurisdictions. Barriers

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

    Microsoft Academic Search

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

    2012-01-01

    BackgroundMigrant Asian women reportedly have low levels of contraceptive use and high rates of abortion in New Zealand. Chinese make up the largest proportion of migrant Asian in New Zealand. This study aimed to describe the contraceptive choices of Chinese women seeking abortion; to examine method choice in relation to demographic characteristics (including length of stay) and to determine whether

  14. Using Pharmacies in Washington State To Expand Access to Emergency Contraception

    Microsoft Academic Search

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

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

  15. 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…

  16. Ulipristal acetate: contraceptive or contragestive?

    PubMed

    Keenan, Jeffrey A

    2011-06-01

    Ulipristal acetate is the first selective progesterone receptor modulator approved for postcoital contraception in the US. It appears to be significantly more effective in inhibition of ovulation than other forms of emergency contraception. However, ulipristal acetate is structurally similar to mifepristone, and several lines of evidence suggest that a postfertilization mechanism of action is also operative. This mechanism of action is considered to be contragestive versus contraceptive. Ulipristal acetate administration is contraindicated in a known or suspected pregnancy; however, it could quite possibly be used as an effective abortifacient. Health-care providers should inform patients of the possibility of both mechanisms of action with use of this drug. PMID:21666088

  17. [Contraception in adolescent girls: prevention].

    PubMed

    Winaver, D

    1987-06-01

    Contraception for adolescents presents problems for physicians because the pediatricians and child psychologist with the greatest knowledge of adolescents are not the ones who prescribe contraception. Customary medical procedures may be inadequate for dealing with adolescents. Older women consulting for contraception usually themselves decide what method to choose, and their resistence to contraception and ambivalence to pregnancy can be explored. For adolescents, contraception may be a constraint rather than a choice. It may be imposed despite their conflicting desire for pregnancy and motherhood. Adolescents are usually accompanied by another person, who may make establishment of rapport difficult. If communication is not possible, it can be suggested that the examination be postponed. Attentive patience may eventually permit the examination to progress. The attitudes, preconceived notions, and emotions of the physician may prevent establishment of rapport with the adolescent patient. When contraception is imperative, there are usually no great risks in prescribing oral contraceptives even if the examination is refused. If the examination is done, the parts of the genital anatomy should be named and perhaps shown in a mirror to reassure the client that she is "normal", an important concern at this age. The examination should be used as an occasion to provide adolescents with the information they need to prevent gynecological and breast disorders, sexually transmitted diseases, cervical cancer, and other problems, and to seek prompt treatment if necessary. The immature reproductive systems and immune defenses of adolescent patients limit contraceptive choices for them, but lack of contraception brings its own serious risks of unwanted pregnancy, abortion, ectopic pregnancy, and even eventual sterility. Oral contraceptives (OCs) are completely effective, provide protection against some pelvic infections, and are safe when contraindications have been ruled out. OCs can be used before sexual activity commences, without risk to later fertility, and no interruption of the sexual act. OCs are generally well tolerated, but the daily discipline they require may be beyond the capabilities of some adolescents. The formulation should be changed if needed. Local methods provide some protection against sexually transmitted diseases but they are expensive and perhaps difficult for adolescents to obtain. Condoms can be useful if the male agrees to use them. Natural methods are unsuitable in very young girls with unstable cycles. IUDs are almost always contraindicated for adolescents because of the heightened risk of infection. Contraceptive methods should only be proposed for adolescents, never imposed. The physician should be readily available to answer questions. In the final analysis, a medical consultation is probably not the ideal approach to providing contraceptive information for adolescents, specialized centers or families might be better. PMID:12280893

  18. 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

  19. Emergency contraception: update and review.

    PubMed

    Langston, Aileen

    2010-03-01

    Emergency contraception (EC) is the postcoital method of pregnancy prevention. Three methods of EC are used in the United States: (1) levonorgestrel-only pills, Plan B (Barr Pharmaceuticals, LLC, New Jersey) (2) combined estrogen and progestin pills, and (3) the copper intrauterine device. Used within 120 hours after unprotected sexual intercourse, EC reduces the risk of pregnancy by 60 to 94%. EC is a critical component of medical care for sexual assault survivors, and several states have laws mandating this standard of care. Levonorgestrel-only EC is available to women >or=17 years of age without a prescription. Women who were counseled by their clinician about EC were 11 times more likely to use EC in the following 12 months. Advance provision of EC to women has not been found to decrease rates of unintended pregnancy compared with routine pharmacy access; however, women routinely prefer advance provision. The newly approved by the Food and Drug Administration single-dose EC, Plan B One-Step (Barr Pharmaceuticals, LLC), may affect unintended pregnancy rates among EC users by simplifying use. PMID:20352558

  20. Non-Contraceptive Benefits of Oral Hormonal Contraceptives

    PubMed Central

    Schindler, Adolf E

    2012-01-01

    Abstract It is becoming evident that oral hormonal contraceptives-besides being well established contraceptives-seem to become important medications for many functional or organic disturbances. So far, clinical effectiveness has been shown for treatment as well as prevention of menstrual bleeding disorders and menstrual-related pain symptoms. Also this is true for premenstrual syndrome (PMS) and premenstrual disphoric disorder (PMDD). Particular oral contraceptives (OCs) containing anti-androgenic progestogens were shown to be effective medications for treatment of androgenisation symptoms (seborrhea, acne, hirsutism, alopecia). Through perfect suppression of the hypothalamic-pituitary-ovarian axis OCs have proven to be effective in elimination of persistent follicular cysts. Endometriosis/adenomyosis related pain symptoms are well handled similar to other drugs like Gonadotropine Releasing Hormone agonists but are less expensive, with less side effects, and possibility to be used for longer periods of time. This is also true for myoma. Pelvic inflammatory disease, rheumatoid arthritis, menstrual migraine, and onset of multiple sclerosis are prevented or delayed. Bone density is preserved and asthma symptoms improved. Endometrial hyperplasia and benign breast disease can be controlled. There is definitely a significant impact on risk reduction regarding endometrial, ovarian, and colon cancers. In conclusion, it needs to be recognized that oral combined hormonal contraceptives (estrogen/ progestogen combination) are - besides being reliable forms of contraception - are cost-effective medications for many medical disorders in women. Therefore, these contraceptives drugs are important for female and global health and should be used in clinical practice. PMID:23853619

  1. Psychiatric Comorbidity in Women With Binge Eating Disorder: Prevalence Rates From a Non-Treatment-Seeking Sample

    Microsoft Academic Search

    Christy F. Telch; Eric Stice

    1998-01-01

    This study provides estimates of comorbid psychiatric disorders in women with binge eating disorder (BED). Sixty-one BED and 60 control participants, who were recruited from the community, completed the Structured Clinical Interview for DSM–III–R Axis I and Axis II disorders and self-report measures of eating and general psychiatric symptomatology. Regarding psychiatric diagnoses, women with BED had higher lifetime prevalence rates

  2. Psychiatric Comorbidity in Women With Binge Eating Disorder Prevalence Rates From a Non-Treatment-Seeking Sample

    Microsoft Academic Search

    Christy F. Telch

    2000-01-01

    This study provides estimates of comorbid psychiatric disorders in women with binge eating disorder (BED). Sixty-one BED and 60 control participants, who were recruited from the community, completed the Structured Clinical Interview for DSM—III—R Axis I and Axis II disorders and self-report measures of eating and general psychiatric symptomatology. Regarding psychiatric diagnoses, women with BED had higher lifetime prevalence rates

  3. Teenagers, contraception, and pregnancy.

    PubMed

    Dickens, H O; Mudd, E H; Huggins, G R

    1975-04-01

    The Hospital of the University of Pennsylvania started a family planning counseling program for teenage nulliparae in a nearby public high school in 1973-1974. Educational, informal counseling, and discussion sessions were held in the school on a weekly basis by a social worker, family planning nurse, family planning counselor, and male outreach worker. Following the classes, almost half the girls attended the hospital's Teen Clinic for physical examination and contraceptive supplies. Parental permission was not necessary for attendance at the classes or at the hospital clinic. A second program was started at another school in the year 1974-1975. The goal of the program was to offer family planning information in the early teen years and prevent unwanted pregnancy. PMID:12334107

  4. JAMA Patient Page: Oral Contraceptives

    MedlinePLUS

    ... painful periods or premenstrual syndromes, polycystic ovarian syndrome, acne, uterine fibroids, and endometriosis. Other Considerations It is ... contraception.htm To find this and previous JAMA Patient Pages, go to the Patient Page link on ...

  5. Emerging options for emergency contraception.

    PubMed

    Koyama, Atsuko; Hagopian, Laura; Linden, Judith

    2013-02-18

    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

  6. Media exposure increases contraceptive use.

    PubMed

    Retherford, R D; Mishra, V

    1997-08-01

    India's national family welfare program has been broadcasting family planning messages on the radio and television for many years. The electronic mass media play a major role in teaching women about the benefits of small families and providing them with information on contraception. Radio and television are particularly important in India, a country in which 63% of currently married reproductive-age women are illiterate. An analysis of nationally representative data from India's 1992-93 National Family Health Survey (NFHS) on 84,558 currently married women aged 13-49 years indicates that general exposure to radio, television, and cinema has a strong positive effect upon current contraceptive use and the intended future use of contraception. Specific exposure to family planning messages has a significant positive effect upon current and intended future contraceptive behavior beyond the general effect of media exposure. PMID:12293013

  7. Progestin-Only Oral Contraceptives

    MedlinePLUS

    ... oral contraceptives are a very effective method of birth control, but they do not prevent the spread of ... on another day, use a backup method of birth control (such as a condom and/or a spermicide) ...

  8. The contraception needs of the perimenopausal woman.

    PubMed

    Hardman, Sarah M R; Gebbie, Ailsa E

    2014-08-01

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

  9. Contraceptive practices and pregnancy intendedness among pregnant adolescents

    PubMed Central

    Lanjakornsiripan, Wakul; Amnatbuddee, Siriruthai; Seejorn, Kanok; Werawatakul, Yuthapong; Kleebkaow, Pilaiwan; Komwilaisak, Ratana; Luanratanakorn, Sanguanchoke

    2015-01-01

    Background Adolescent pregnancy is a major health problem in many developing countries. Objective To assess contraceptive practices and pregnancy intendedness in pregnant adolescents. Materials and methods This study was prospectively conducted from September 2013 to June 2014. All consecutively pregnant women between 15 and 19 years old attending the Antenatal Clinic at Srinagarind Hospital and the Khon Kaen Branch of the Planned Parenthood Association of Thailand were invited for participation. Face-to-face interviews by trained interviewers using standardized questionnaires were carried out. Logistic regression was used to determine an adjusted odds ratio (aOR) and 95% confidence interval (CI) of independent predictors. Results Two hundred participants were enrolled. Mean age was 17.2 years. One hundred and eighteen (59.0%) were currently in school. Seventy-five (37.5%) participants had never used any contraceptive methods. Of the 125 participants who had ever used contraception, regular use of contraceptives was reported in only 21 participants (16.8%). Only two participants (1.0%) had ever used an intrauterine device or implant. Participants’ age was a significant independent factor associated with non-use of contraceptives (aOR, 6.42; 95% CI, 2.94–14.04). Of the 200 participants, 132 (66.0%) declared that the pregnancy was unintended. Significant independent factors predicting unintended pregnancy were educational status (aOR, 6.17; 95% CI, 3.27–13.75) and participants’ age (aOR, 5.76; 95% CI, 2.42–13.70). Conclusion Non-use and use of contraceptive methods with high failure rates were major reasons leading to adolescent pregnancies. Participants’ age was an independent factor predicting non-use of contraceptives. Educational status and age of the participants were significant factors predicting unintended pregnancy. PMID:25848322

  10. Patterns of contraceptive use among Mexican-origin women

    PubMed Central

    White, Kari L.; Potter, Joseph E.

    2015-01-01

    BACKGROUND Mexican women in the United States (US) have higher rates of fertility compared to other ethnic groups and women in Mexico. Whether variation in women’s access to family planning services or patterns of contraceptive use contributes to this higher fertility has received little attention. OBJECTIVE We explore Mexican women’s contraceptive use, taking into account women’s place in the reproductive life course. METHODS Using nationally representative samples from the US (National Survey of Family Growth) and Mexico (Encuesta National de la Dinámica Demográfica), we compared the parity-specific frequency of contraceptive use and fertility intentions for non-migrant women, foreign-born Mexicans in the US, US-born Mexicans, and whites. RESULTS Mexican women in the US were less likely to use IUDs and more likely to use hormonal contraception than women in Mexico. Female sterilization was the most common method among higher parity women in both the US and Mexico, however, foreign-born Mexicans were less likely to be sterilized, and the least likely to use any permanent contraceptive method. Although foreign-born Mexicans were slightly less likely to report that they did not want more children, differences in method use remained after controlling for women’s fertility intentions. CONCLUSION At all parities, foreign-born Mexicans used less effective methods. These findings suggest that varying access to family planning services may contribute to variation in women’s contraceptive use. COMMENTS Future studies are needed to clarify the extent to which disparities in fertility result from differences in contraceptive access.

  11. Estimating HIV prevalence from surveys with low individual consent rates: annealing individual and pooled samples.

    PubMed

    Hund, Lauren; Pagano, Marcello

    2013-01-01

    : Many HIV prevalence surveys are plagued by the problem that a sizeable number of surveyed individuals do not consent to contribute blood samples for testing. One can ignore this problem, as is often done, but the resultant bias can be of sufficient magnitude to invalidate the results of the survey, especially if the number of non-responders is high and the reason for refusing to participate is related to the individual's HIV status. One reason for refusing to participate may be for reasons of privacy. For those individuals, we suggest offering the option of being tested in a pool. This form of testing is less certain than individual testing, but, if it convinces more people to submit to testing, it should reduce the potential for bias and give a cleaner answer to the question of prevalence. This paper explores the logistics of implementing a combined individual and pooled testing approach and evaluates the analytical advantages to such a combined testing strategy. We quantify improvements in a prevalence estimator based on this combined testing strategy, relative to an individual testing only approach and a pooled testing only approach. Minimizing non-response is key for reducing bias, and, if pooled testing assuages privacy concerns, offering a pooled testing strategy has the potential to substantially improve HIV prevalence estimates. PMID:23446064

  12. Ulipristal acetate for emergency contraception.

    PubMed

    Russo, J A; Creinin, M D

    2010-09-01

    Ulipristal acetate is a progesterone receptor modulator. As an emergency contraceptive, a 30-mg micronized formulation is effective for use up to 120 h from unprotected sexual intercourse. Ulipristal acetate acts as an antagonist of the progesterone receptor at the transcriptional level and a competitive antagonist of glucocorticoid receptor function. In contrast to other contraceptives, it has little effect on sex hormone-binding globulin. Although a single small study demonstrated some potential endometrial effects after ulipristal acetate administration, the clinical relevance of these findings is unclear. The incidence of adverse events in clinical trials for emergency contraception has typically been minimal, with one study showing a higher than expected incidence of nausea upon ulipristal acetate use. Ulipristal acetate, like other emergency contraceptive products, can lengthen the time to the next expected menstruation. Ulipristal acetate may have several advantages over currently approved emergency contraceptives. When compared to levonorgestrel, ulipristal acetate maintains its efficacy for a full 120 h, whereas levonorgestrel formulations have declining efficacy over that time frame. Moreover, although the copper intrauterine device (IUD) is highly effective as an emergency contraceptive, accessibility is an issue since the IUD requires a skilled provider for insertion. PMID:20967297

  13. Ulipristal acetate in emergency contraception.

    PubMed

    Goldstajn, Marina Sprem; Baldani, Dinka Pavici?; Skrgati?, Lana; Radakovi?, Branko; Vrbi?, Hrvoje; Cani?, Tomislav

    2014-03-01

    Despite the widespread availability of highly effective methods of contraception, unintended pregnancy is common. Unplanned pregnancies have been linked to a range of health, social and economic consequences. Emergency contraception reduces risk of pregnancy after unprotected intercourse, and represents an opportunity to decrease number of unplanned pregnancies and abortions. Emergency contraception pills (ECP) prevent pregnancy by delaying or inhibiting ovulation, without interfering with post fertilization events. If pregnancy has already occurred, ECPs will not be effective, therefore ECPs are not abortificants. Ulipristal acetate (17alpha-acetoxy-11beta-(4N-N,N-dymethilaminophenyl)-19-norpregna--4,9-diene-3,20-dione) is the first drug that was specifically developed and licensed for use as an emergency contraceptive. It is an orally active, synthetic, selective progesterone modulator that acts by binding with high affinity to the human progesterone receptor where it has both antagonist and partial agonist effects. It is a new molecular entity and the first compound in a new pharmacological class defined by the pristal stem. Up on the superior clinical efficacy evidence, UPA has been quickly recognized as the most effective emergency contraceptive pill, and recently recommended as the first prescription choice for all women regardless of the age and timing after intercourse. This article provides literature review of UPA and its role in emergency contraception. PMID:24851646

  14. Classification of eating disorders: comparison of relative prevalence rates using DSM-IV and DSM-5 criteria.

    PubMed

    Mancuso, Serafino G; Newton, J Richard; Bosanac, Peter; Rossell, Susan L; Nesci, Julian B; Castle, David J

    2015-06-01

    DSM-5 contains substantial changes to eating disorder diagnoses. We examined relative prevalence rates of DSM-IV and DSM-5 eating disorder diagnoses using Eating Disorder Examination-Questionnaire diagnostic algorithms in 117 community out-patients. DSM-5 criteria produced a reduction in combined 'other specified feeding or eating disorder' and 'unspecified feeding or eating disorder' from 46% to 29%, an increase in anorexia nervosa diagnoses from 35% to 47%, the same number of bulimia nervosa diagnoses and a 5% rate of binge eating disorder diagnoses. PMID:25745131

  15. Family size, sex composition of children and contraceptive use: a case study of Kerala.

    PubMed

    Suchindran, C M; Ramakumar, R; Sathi Devi, K

    1993-01-01

    With the sudden decline of fertility it was particularly interesting to examine the situation in Kerala, regarding parental sex preference in formulating family planning policies for the rest of India with high fertility and son preference. The 1980 Kerala Fertility Survey included nearly 3000 households with about 2700 ever married women in reproductive age. Maternity history and fertility regulation data were collected. Data from 2500 currently married women were used, cross-classified by the number of male and female living children and contraceptive use status. A multiplicative model was used to study various interaction effects and to construct standardized rates of contraceptive use. Measures adjusted for both male and female composition and differential use of contraceptives among male-female combinations were obtained by the model to avoid arbitrariness in choosing rates and to preclude objections raised in previous research on Arnold's index. The model was generalized to facilitate simultaneous effects of the number of male and female children and family size on contraceptive use. Initial analysis showed that the effect of sex preference on contraceptive acceptance was rather negligible. However, there was a significant male-female interaction effect on contraceptive use. Contraception was high when the family size was large, with children of the same sex. With the effect of family size removed, the contraceptive use rate seemed to be in the inverse direction of the number of male or female children. This was possibly the result of two factors: 1) high contraception rate with large families of the same sex, and 2) low use of contraception among large families with a high number of children of both sexes. The Kerala situation partly supports McClelland's theory that couples already having proportionally more daughters may terminate fertility earlier. In Kerala such termination also occurs when couples have proportionally more sons, and family size also plays an important role in fertility cessation. PMID:12345254

  16. 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

  17. Adjusting HIV Prevalence for Survey NonResponse Using Mortality Rates: An Application of the Method Using Surveillance Data from Rural South Africa

    Microsoft Academic Search

    Makandwe Nyirenda; Basia Zaba; Till Bärnighausen; Victoria Hosegood; Marie-Louise Newell; Landon Myer

    2010-01-01

    BackgroundThe main source of HIV prevalence estimates are household and population-based surveys; however, high refusal rates may hinder the interpretation of such estimates. The study objective was to evaluate whether population HIV prevalence estimates can be adjusted for survey non-response using mortality rates.Methodology\\/Principal FindingsData come from the longitudinal Africa Centre Demographic Information System (ACDIS), in rural South Africa. Mortality rates

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

    PubMed

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

    2015-03-01

    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 9 months postpartum. 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 4 months postpartum and 9 months postpartum and we used logistic regression to assess the correlates of IPV during this time. 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 9 months postpartum. Psychological IPV was the most prevalent type of IPV during pregnancy and the first 4 months postpartum. Age and previous violence within the relationship were associated with IPV during pregnancy and IPV during the postpartum period. 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

  19. 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

  20. 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

  1. 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

  2. Combined Oral Contraceptive Pills: Profile of Acceptors in a Tertiary Hospital in South-South Nigeria

    PubMed Central

    Abasiattai, A. M; Utuk, M. N; Ojeh, S. O; Eyo, U E

    2011-01-01

    Background: Combined oral contraceptive pills were the first contraceptive method to provide sexual freedom of choice for women through reliable, personal and private control of fertility. They are the most widely used hormonal contraceptives and also the most popular non-surgical method of contraception. Objective: To review the profile of acceptors of combined oral contraceptive pills at the University of Uyo Teaching Hospital, Uyo. Methodology: An 8 year review of all clients that accepted combined oral contraceptive pills in the family planning clinic. Results: There were 1,146 new contraceptive acceptors during the period of study out of which 309 (27.9%) accepted the pills. Majority of the clients were between 20 and 29 years of age (54.0%), were multiparous (72.8%), Christians (99.7%) and 61.2% had tertiary level education. Two hundred and fifty-five women (82.5%) desired to use combined oral contraceptive pills to space births while 7.8% wanted to limit child bearing. There was a high discontinuation rate among the women (45.0%) and out of these 87.9% of the clients changed to other contraceptive methods. All the clients commenced their pills within seven days of menstruation and only the low dose monophasic preparations were available in the family planning unit and thus were given to the clients. Conclusion: Women who accept to initiate combined oral contraceptive pills in our center are young, well educated, multiparous women who want to space their pregnancies. However, due to the high discontinuation rate among the clients, there is need for further studies evaluating reasons for the high discontinuation rate, exploring interactions between clients and providers’ and also providers’ attitude towards combined pills in our environment. PMID:21969170

  3. Contraceptive use in a changing service environment: evidence from Indonesia during the economic crisis.

    PubMed

    Frankenberg, Elizabeth; Sikoki, Bondan; Suriastini, Wayan

    2003-06-01

    In the late 1990s, most Southeast Asian countries experienced substantial economic downturns that reduced social-sector spending and decreased individuals' spending power. Data from Indonesia were collected in 1997 (just before the crisis) and in 1998 (during the crisis) that are used in this study to examine changes in the contraceptive supply environment and in women's choices regarding contraceptive use. Despite substantial changes in providers' characteristics during the first year of the crisis, no statistically significant differences are found between 1997 and 1998 in overall levels of prevalence, in unmet need, or in method mix. Women's choices regarding source of contraceptive supplies, however, changed considerably over the period. Changes in the contraceptive supply environment are linked here to changes in women's choice of source of supply, and a number of providers' characteristics are found to be significantly associated with women's choices in this regard. PMID:12889342

  4. Increasing contraceptive use in Bangladesh: the role of demand and supply factors.

    PubMed

    DeGraff, D S

    1991-02-01

    This article analyzes the determinants of contraceptive use in Bangladesh, focusing on the roles of demand for additional children and of family planning service supply. Data from the Matlab Family Planning Health Services Project are used to examine the contributions of these factors to the difference in prevalence of modern contraceptive use between the project area and a control area served by the government family planning and health programs. Results of multivariate analysis deriving from the Easterlin synthesis framework show the importance of family planning supply factors in reducing psychic and resource costs of fertility regulation and in activating latent demand for contraception. Demand for birth limiting and for birth spacing emerge as important explanatory factors; demand for birth spacing is greater in the project area, and both demand measures exert a stronger effect on contraceptive behavior in that area. PMID:2015945

  5. Television and contraception.

    PubMed

    Klein, L

    1986-01-01

    This article consists of excerpts from a speach made on October 19th at the 1986 annual meeting of the Association of Planned Parenthood Professionals by Dr. Luella Klein, President of the American College of Obstetricians and Gynecologists (ACOG) between 1984-85. The speaker described the reaction of US television network to the ACOG's request that the networks air a public service announcement encouraging responsible sexual behavior among the nation's young people. In 1984 the ACOG initiated a public information program aimed at reducing the high number of unwanted births among young people. The ACOG with the help of an advertising agency developed a 27-second public service announcement stressing responsible parenthood and informing young people that they could write or call for further information. A booklet, entitled "Facts," was prepared for distribution to those who inquired. It advised young people to consider postponing sexual intercourse but to use the most effective methods of contraception if they decided to be sexually active. Oral contraceptives for females and condoms for males were recommended as the most effective methods. When the 3 major television networks, i.e., the American Broadcasting Company (ABC), the National Broadcasting Company (NBC), and the Columbia Broadcasting System (CBS), were requested to carry the announcement, all 3 networks claimed the announcement was too controversial to air. These same networks do not hesitate to show blatant, irresponsible sexual behavior repeatedly during their entertainment programming, and commercials with sexual innuendos are routinely accepted for airing by the networks. In July, 1986, the ACOG called a news conference in New York City to inform the news media about the rejection of the announcement by the networks. The conference stimulated considerable interest, and the story was carried by many newspapers and by radio and television news programs. Many of the news accounts of the story contained the public service announcement itself. As a result, young people began calling and writing for the booklet. Editorials critical of the networks' handling of the ACOG request appeared in numerous publications. The author then wrote to the presidents of each network asking them to reconsider the ACOG request. The presidents of ABC and CBS flatly rejected the request, but the president of NBC agreed to meet with the ACOG to work out an acceptable announcement. The networks must be encouraged to promote a more responsible and realistic image of sexual behavior than the image currently being conveyed in television programs and ads. PMID:12340617

  6. 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

  7. Effect of advanced provision of emergency contraception on women's contraceptive behaviour: a randomized controlled trial

    Microsoft Academic Search

    Sue S. T. Lo; Susan Y. S. Fan; P. C. Ho; Anna F. Glasier

    2004-01-01

    BACKGROUND: Emergency contraception (EC) can prevent pregnancy but is under-used. Advanced provision increases use but the effect on contraceptive behaviour varies. METHODS: Women aged 18 -45 years, using less effective contraceptives, were randomized to either advanced provision of three courses of EC (intervention) or to obtaining each course from clinic (control). EC use and contraceptive behaviour were monitored for 1

  8. 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

  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. Contraceptive coverage laws proliferate in 1999.

    PubMed

    Dailard, C

    1999-12-01

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

  11. Contraception and Birth Control: Other FAQs

    MedlinePLUS

    ... Information Clinical Trials Resources and Publications Contraception and Birth Control: Other FAQs Skip sharing on social media links ... choose a method of contraception? The choice of birth control depends on many factors. Before deciding on a ...

  12. Contraceptive research and development.

    PubMed

    Aitken, R J

    1979-05-01

    Contraceptive research and development is primarily performed at universities and research councils due to the cost and time involved for industry and philanthropic organizations to bring drugs to market. Promising fundamental research includes immunization of women against chorionic gonadotrophin in order to disrupt the embryo in early pregnancy. Post-coital drugs, such as Anordrin, are also being developed for situations involving low-coital frequency. Once-a-month formulas are being developed to 1) exert a direct luteolytic effect on the corpus luteum; 2) interfere with the luteotrophic action of the implanting blastocyst; 3) inhibit the progestational development of the endometrium during the luteal phase of the cycle; or 4) exert a specific toxic effect on the early embryo. Methods for detecting ovulation incuding urine and saliva tests as well as electronic devices to measure the blood flow or temperature associated with ovulation are also being explored. Reversible fertility control for men which suppress the pituitary function is under investigation. Applied research includes the design and assessment of alternate delivery systems such as intranasal sprays, intracervical devices, paper pills, vaginal rings, and biodegradable subdermal implants. In addition, long-acting injectable progestins, improved IUDs, and improved sterilization techniques are all being tested. With future funds, the comparative safety, efficacy, and acceptability of various fertility methods can be established. PMID:387168

  13. 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

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

    PubMed

    David, M; Berends, L; Bartley, J

    2012-11-01

    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

  15. 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

  16. Emergency contraception: an updated review.

    PubMed

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

    2011-09-01

    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

  17. Emergency contraception: why can't you give it away? Qualitative findings from an evaluation of advance provision of emergency contraception

    Microsoft Academic Search

    Karen Fairhurst; Sue Ziebland; Sally Wyke; Peter Seaman; Anna Glasier

    2004-01-01

    The Lothian Emergency Contraception Project (LECP)—a primary care-based intervention to offer advance supplies of emergency contraception (EC) to women aged 16–29 was not associated with a reduction in abortion rates. We undertook case studies, utilizing qualitative and quantitative methods, to evaluate the intervention. In this article we present findings from qualitative interviews with 44 primary care professionals working at case

  18. Oral contraceptives and liver function

    PubMed Central

    Hargreaves, Tom

    1969-01-01

    Oral contraceptives can cause liver damage and jaundice but this is very rare in women in the United Kingdom. The drugs are contraindicated where there is a history of recurrent intrahepatic cholestasis of pregnancy and acute or chronic disturbance of liver function which can be congenital or acquired. It is not yet known whether the oestrogenic or progestogenic components of oral contraceptives cause the hepatic abnormalities. The available data suggest that neither oestrogens nor progestogens in low doses impair hepatic excretory processes. The full implications of the continued administration of oestrogens and progestogens for many years on liver proteins are not yet known.

  19. Examining the prevalence rate of Pediculus capitis infestation according to sex and social factors in primary school children

    PubMed Central

    Doroodgar, Abbas; Sadr, Fakhraddin; Doroodgar, Masoud; Doroodgar, Moein; Sayyah, Mansour

    2014-01-01

    Objective To determine the prevalence rate of head louse infestation among elementary students, and examine the associated factors with infection in the city of Aran and Bidgol. Methods A total of 19 boys' and girls' primary schools were selected by multistage, systematic random sampling. Overall, 3?590 students were examined for head lice infestation in urban areas of Aran and Bidgol during 2008. The diagnosis was based on live louse or nit on the scalp of students. The students were screened by standard questionnaire and demographic data in addition to related information were obtained by interview and observation. The data were analyzed by SPSS software using chi-square and Fisher's exact tests. Results The mean age of students was (8.68±1.58) years ranging between 6-12 years. The total prevalence of head louse infestation was 0.47%. This rate was 0.42% and 0.05% in female and male, respectively. There was a significant association between pediculosis and sex, father's job, mother's education, access to bathroom in home, prior infection, drug use and nationality, respectively (P<0.05). Conclusions The results showed that pediculosis was not a major health priority among primary school in city of Aran and Bidgol. However, enhancing the knowledge of students about head lice infestation and the existence of health teachers in schools can play a significant role in disease control.

  20. Effect of missed combined hormonal contraceptives on contraceptive effectiveness: a systematic review?

    PubMed Central

    Zapata, Lauren B.; Steenland, Maria W.; Brahmi, Dalia; Marchbanks, Polly A.; Curtis, Kathryn M.

    2015-01-01

    Background Combined hormonal contraceptives (CHCs) are popular methods of reversible contraception in the United States, but adherence remains an issue as reflected in their lower rates of typical use effectiveness. The objective of this systematic review was to evaluate evidence on the effect of missed CHCs on pregnancy rates as well as surrogate measures of contraceptive effectiveness (e.g., ovulation, follicular development, changes in hormone levels, cervical mucus quality). Study Design We searched the PubMed database for peer-reviewed articles published in any language from database inception through April 2012. We included studies that examined measures of contraceptive effectiveness during cycles with extended hormone-free intervals or nonadherence (e.g., omission of pills, delayed patch replacement) on days not adjacent to the hormone-free interval. We used standard abstract forms and grading systems to summarize and assess the quality of the evidence. Results The search strategy identified 1387 articles, of which 26 met our study selection criteria. There is wide variability in the amount of follicular development and risk of ovulation among women who extended the pill-free interval to 8–14 days; in general, the risk of ovulation was low, and among women who did ovulate, cycles were usually abnormal (i.e., low progesterone levels, small follicles and/or poor cervical mucus) (Level I, good, indirect to Level II-3, fair, indirect). Studies of women who missed one to four consecutive pills or 1–3 consecutive days of delay before patch replacement at times other than adjacent to the hormone-free interval reported little follicular activity and low risk of ovulation (Level I, fair, indirect to Level II-3, poor, indirect). Studies comparing 30 mcg versus 20 mcg mc ethinyl estradiol pills showed more follicular activity when 20 mcg ethinyl estradiol pills were missed (Level I, good, indirect). Conclusion Most of the studies in this evidence base relied on surrogate measures of pregnancy risk and ranged in quality. For studies providing indirect evidence on the effects of missed CHCs, it is unclear how differences in surrogate measures correspond to pregnancy risk. Fewer studies examined the transdermal patch and vaginal ring than combined oral contraceptives. PMID:23083527

  1. Prevalence of the sling effect for enhancing collision rates in turbulent suspensions

    E-print Network

    kuhle, Michel Voß; Lévêque, Emmanuel; Wilkinson, Michael

    2013-01-01

    Turbulence facilitates collisions between particles suspended in a turbulent flow. Two effects have been proposed which can enhance the collision rate at high turbulence intensities: 'preferential concentration' (a clustering phenomenon) and the 'sling effect' (arising from the formation of caustic folds in the phase-space of the suspended particles). We have determined numerically the collision rate of small heavy particles as a function of their size and densities. The dependence on particle densities reveals that the enhancement by turbulence of the collision rate of particles with significant inertia is due almost entirely to the sling effect.

  2. 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

  3. Unmet need for contraception among HIV-positive women in Lesotho and implications for mother-to-child transmission.

    PubMed

    Adair, Timothy

    2009-03-01

    In Lesotho, the risk of mother-to-child-transmission (MTCT) of HIV is substantial; women of childbearing age have a high HIV prevalence rate (26.4%), low knowledge of HIV status and a total fertility rate of 3.5 births per woman. An effective means of preventing MTCT is to reduce unwanted fertility. This paper examines the unmet need for contraception to limit and space births among HIV-positive women in Lesotho aged 15-49 years, using the 2004 Lesotho Demographic and Health Survey. HIV-positive women have their need for contraception unmet in almost one-third of cases, and multivariate analysis reveals this unmet need is most likely amongst the poor and amongst those not approving of family planning. Urgent action is needed to lower the level of unmet need and reduce MTCT. A constructive strategy is to improve access to family planning for all women in Lesotho, irrespective of HIV status, and, more specifically, integrate family planning with MTCT prevention and voluntary counselling and testing services. PMID:18847526

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

    Microsoft Academic Search

    Sajeda Amin; Alaka Malwade Basu; Rob Stephenson

    2000-01-01

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

  5. Sexual Activity and Contraceptive Use among Children Entering Out-of-Home Care.

    ERIC Educational Resources Information Center

    Risley-Curtiss, Christina

    1997-01-01

    Explored prevalence and ability of selected factors to explain sexual activity and use of contraceptives among a cohort of children entering out-of-home care. Found that children as young as 8 reported sexual activity and more than one-third between ages 8 and 18 are sexually active. Identified five important variables in sexual activity and two…

  6. The Role of Place in Shaping Contraceptive Use among Women in Africa

    PubMed Central

    Elfstrom, K. Miriam; Stephenson, Rob

    2012-01-01

    Background Contraceptive prevalence is low in the African region despite considerable family planning programmatic efforts. This study is the first to examine how community factors shape contraceptive use for married women in an entire region, comparing results across 21 African countries with a DHS in the last 5 years. The analysis builds on previous studies through an examination of the individual, household and community level factors that shape contraceptive use. Methods The data used in this analysis were from nationally representative Demographic and Health Surveys completed between 2005 and 2009. A separate multi-level logistic model was fitted for the outcome of current modern contraceptive use in each country. Results After controlling for individual and household level factors, community level factors of demographics and fertility norms, gender norms and inequalities, and health knowledge remain significantly associated with contraceptive use, although the magnitude and direction of these community effects varied significantly across countries. Conclusions The results highlight the importance of harnessing community level factors in planning interventions for increasing access to and utilization of modern contraceptive methods. PMID:22815784

  7. 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…

  8. Clotting factors after emergency contraception

    Microsoft Academic Search

    A. Webb; D. Taberner

    1993-01-01

    Women with a previous history of thromboembolic disease have often been denied oral emergency contraception because of a theoretical concern about increasing their risk of thrombosis. Methods Eleven healthy volunteers with regular periods were recruited to the study. A thrombophilia screen was done at the first visit and they each had four measurements of Factor VII and antithrombin III taken

  9. Oral contraception: risks and benefits

    Microsoft Academic Search

    W. M. Steinberg

    1989-01-01

    Summary Data on the risks and benefits of using the oral contraceptive continue to accumulate. Because of continuing changes in the formulation and dosage of both the estrogens and progestins, the medical community must constantly re-evaluate all older data when considering current risk\\/benefit ratios. The changes in pill formulation have led to increased acceptability with a reduction of both nuisance

  10. [Endemic onchocerciasis in forested zones of Ivory Coast: prevalence rate and microfilarial densities].

    PubMed

    Diarrassouba, S; Traore, S; Riviere, F

    1996-01-01

    Since 1974 grassy plain areas of the western Africa have been protected by the Onchocerciasis Control Programme, but wooded endemic areas are also of concerned to countries in the region. Numerous studies have been performed to study endemic features of onchocerciasis in wooded areas. A parasitologic/entomologic survey was conducted between April and October 1990 in 5 villages in wooded areas located in Cote d'Ivoire. The parasitologic survey consisted of blood-free skin snips taken from both iliac crests of all subjects one year or over. Microfilarial counts performed after soaking biopsy material in distilled water for 30 minutes allowed characterization of the disease in the area. Overall microfilariae were found in 60.51% of the population indicating that onchocerciasis was highly endemic. The level of endemicity varied from one village to another. Prevalence was same in the two sexes and increased with age. Microfilarial density was the same in men and women up to the age of 9 years. After that time the density was at least twofold higher in men than in women at the same age. Although onchocerciasis is highly endemic in the area, blindness is uncommon. PMID:8767795

  11. 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

  12. 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

  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. Receiving voluntary family planning services has no relationship with the paradoxical situation of high use of contraceptives and abortion in Vietnam: a cross-sectional study

    PubMed Central

    2012-01-01

    Background Vietnam shows a paradoxical situation where high contraceptive prevalence goes together with high abortion rates. This study examined the associations between self-reports of having received voluntary family planning (VFP) services and induced abortions. Methods A cross sectional survey was conducted in Thai Nguyen province, covering a total of 1281 women. Data were derived from a sample of 935 married women aged 18–49?years who were ever-users (93.5%) and current users of contraceptives (84%), and had completed birth histories. The dependent variables were the likelihood of having an induced abortion and repeated (two or more) induced abortions. The main independent variable was having received the three VFP dimensions (counselling, broader information, and access to availability). The association was examined using multivariate logistic regressions, taking into account women’s socio-demographic characteristics. Results The overall induced abortion percentage was 19.4 per 100 pregnancies. None of the three VFP dimensions was significantly associated with the odds of having an induced abortion or having repeated induced abortions. Mother’s age of 35 or older, having more than three living children, and ever used female contraception methods significantly doubled or more the odds of having an induced abortion and significantly tripled the odds of having repeated abortions. Conclusions Results indicate that women receiving VFP services were not less likely to have induced abortions. The provision of family planning counselling, information on contraceptive method mix, and management skills to ensure availability, are in need of reinforcement in a new set of policy and program strategies in the future. PMID:22639926

  15. Emergency contraception - potential for women's health.

    PubMed

    Mittal, Suneeta

    2014-11-01

    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

  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. Long Acting Contraception Provision by Rural Primary Care Physicians

    PubMed Central

    Smith, Paul; Grewal, Manpreet; Kumaraswami, Tara; Cowett, Allison; Harwood, Bryna

    2014-01-01

    Abstract Objectives: Unplanned pregnancy is a public health problem in the United States, including in rural areas. Primary care physicians are the main providers of health care to women in rural areas and are uniquely positioned to help reduce unplanned pregnancy in rural women. This study documents provision of contraception by rural primary care physicians, focusing on the most effective, long acting methods, intrauterine devices (IUDs) and contraceptive implants. Methods: We surveyed all primary care physicians practicing in rural areas of Illinois and Wisconsin. Bivariate analysis was performed using chi squared and Fisher's exact test, and multivariable analysis was performed with logistic regression to determine factors associated with provision. Results: The response rate was 862 out of 2312 physicians (37%). Nine percent of respondents place implants and 35% place IUDs. Eighty-seven percent of physicians had not had training in implant placement, and 41% had not had training in IUD placement. In multivariable analysis, factors associated with placement of long acting contraception include provision of maternity care, and female gender of the physician. The most common reasons for not providing the methods were lack of training and perceived low demand from patients. Conclusions: Many rural primary care providers do not place long acting contraceptive devices due to lack of training. Female physicians and those providing maternity care are the most likely to place these devices. Increased training for primary care physicians both during and after residency would help increase access to these options for women in rural areas. PMID:24443930

  18. Cervical dysplasia and cancer and the use of hormonal contraceptives in Jamaican women

    Microsoft Academic Search

    Norma McFarlane-Anderson; Patience E Bazuaye; Maria D Jackson; Monica Smikle; Horace M Fletcher

    2008-01-01

    BACKGROUND: This study was conducted to determine whether use of hormonal contraceptives is associated with cervical dysplasia and cancer in a population where there is widespread use of hormonal contraception and the rates of cervical cancer remain high at 27.5\\/100,000. METHODS: A case-control study was conducted among women visiting the colposcopy and gynaelogical clinics at a tertiary referral hospital. Two

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

    PubMed

    Sheoran, Nayantara

    2015-01-01

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

  20. Contraceptive policies affect post-abortion provision of long-acting reversible contraception

    Microsoft Academic Search

    Kirsten M. J. Thompson; J. Joseph Speidel; Vicki Saporta; Norma Jo Waxman; Cynthia C. Harper

    2011-01-01

    BackgroundPlacement of long-acting reversible contraceptives (LARC) — intrauterine devices (IUDs) and the implant — directly after an abortion provides immediate contraceptive protection and has been proven safe.

  1. Search for an Emergency Contraception Provider in the United States

    MedlinePLUS

    ... an Emergency Contraception (Plan B) Provider in the United States Looking for Emergency Contraception NOW? In the U.S., ... pharmacists in some states) near you in the United States who will write prescriptions for emergency contraception or ...

  2. Does dedicated pre-abortion contraception counselling help to improve post-abortion contraception uptake?

    Microsoft Academic Search

    Ahmed S Yassin; Diane Cordwell

    2005-01-01

    ObjectiveMany studies have shown a disappointing periabortion contraceptive uptake. This study investigated whether the provision of dedicated and targeted contraception counselling at the pre-abortion assessment visit can improve the post-abortion contraception uptake.MethodsThe study comprised a 3-month prospective reaudit of the abortion clinic.ResultsOf the 104 women seen during the re-audit period, 96% received post-abortion contraception. The majority (73%) of the women

  3. Contraception and sexual health in obese women.

    PubMed

    Simmons, Katharine B; Edelman, Alison B

    2015-05-01

    As the proportion of women with obesity increases worldwide, understanding the influence of body weight on sexual behavior, fertility, and contraceptive effectiveness is critical for health-care professionals and patients. Although many have theorized that obese women are different from normal-weight women regarding sexual health and behavior, current evidence for the most part disproves this. The exception is in adolescents where body image may play a role in riskier behavior, placing them at a greater risk of an unintended pregnancy. Given that most modern contraceptives were not originally evaluated in obese women, understanding how weight affects contraceptive pharmacokinetics and efficacy should be a focus of ongoing research. Evidence is reassuring that most modern contraceptive methods are safe and effective in obese women. This paper reviews what is known about sexual and contraceptive behavior, as well as the effectiveness and pharmacokinetics of modern contraceptives, for overweight and obese women. PMID:25498914

  4. [Health risks of oral contraceptives].

    PubMed

    Meier, Christoph R

    2011-06-01

    Oral contraceptives (OC) are either composed of a combination of an estrogen derivative (usually ethinly estradiol) and a progestogen, or they contain a progestogen only. OC are characterized by a high effectiveness and have a low failure rate if taken correctly. Most women tolerate OC relatively well, but adverse effects do occur which are driven by the estrogen dose as well as by the type of progestogen. The most frequently reported adverse effects are nausea or vomiting, breast tenderness, headache or inbalanced mood, but these unwanted side effects are often transient. The fear of weight gain of many OC users is not necessarily supported by data from studies which report relatively little differences in body mass index on average during OC use. Nevertheless, substantial weight gain can occur in individual women. The widely discussed fear of breast cancer is also not justified, and the risk of developing ovarian or endometrial cancer is reduced for women who use OC on a regular basis. Venous thromboembolism (VTE) is the adverse effect with the greatest potential for serious harm if pulmonary embolism develops. This rare, but potentially dangerous adverse effect of OC has been discussed emotionally for many years and keeps attracting a lot of public interest. VTE is rare in young women, but the VTE risk is increased two- to sixfold for OC users as compared to non-users. The VTE risk increases with increasing estrogen dose, is highest in the first year of use, and is higher for OC from the third generation (containing desogestrel, gestodene or norgestimate) than for OC from the second generation (containing levonorgestrel) or than for the progestogen-only pill. According to most studies, OC containing the progestogens drospirenone or cyproterone acetate are similar with regard to VTE risks than OC from the third generation. Individual genetic susceptibility affecting the clotting system plays a major role in the risk of developing VTE in combination with OC, and smoking is also an important contributing factor to an increased VTE risk for women using OC. It is important that doctors and pharmacists inform new users of OC about potential health risks of OC use, and that the personal and family history of previous health risks is assessed thoroughly in order to rule out that important and relevant contraindications are present when a women starts taking OC. PMID:21656494

  5. Update on hormonal contraception and bone density

    Microsoft Academic Search

    Michelle M. Isley; Andrew M. Kaunitz

    2011-01-01

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

  6. Consuming contraceptive control: gendered distinctions in web-based contraceptive advertising

    Microsoft Academic Search

    Stephanie R. Medley-Rath; Wendy Simonds

    2010-01-01

    There are over a hundred contraceptives currently on the market in the USA. In this paper, we present a discourse analysis of the stand-alone websites for 43 contraceptives in an effort to understand what contraceptive manufacturers are selling consumers along with their products. Manufacturers tailor marketing messages to promote conventional sex and gender norms using a scientific discourse. In particular,

  7. Recent innovations in oral contraception.

    PubMed

    Cremer, Miriam; Phan-Weston, Scarlett; Jacobs, Adam

    2010-03-01

    Traditional forms of oral contraception contain 21 days of hormone-containing pills and 7 days of placebo during the hormone-free interval (HFI). Since 2003, the Food and Drug Administration has approved 24/4, 84/7, and 365-day regimens. These regimens shorten the HFI in an attempt to decrease bleeding and menstrual-associated side effects. Safety and efficacy of these regimens is comparable with traditional 21/7 dosing. Extended regimens are associated with high patient satisfaction. Bleeding patterns are similar or shorter in women using extended regimens, along with improvement in menstrual symptoms. One of the new formulations contains the new progestin drospirenone, which has antimineralocorticoid and antiandrogenic properties. This review summarizes the data about new formulations of oral contraception available in the United Sates and also provides a summary of the current literature on drospirenone. PMID:20391327

  8. Behavioral Methods of Contraception

    Microsoft Academic Search

    Jennefer A. Russo; Anita L. Nelson

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

  9. Contraception and sexually transmitted infections

    Microsoft Academic Search

    Judith Stephenson

    2006-01-01

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

  10. Emergency hormonal contraception usage in genitourinary medicine clinic attenders.

    PubMed

    Evans, J K; Holmes, A; Browning, M; Forster, G E

    1996-06-01

    In England, health providers conducted a prospective study of 150 consecutive women 14-43 years old who sought emergency hormonal contraception (EHC) (50 mcg ethinyl estradiol + 500 mcg norgestrel) at the genitourinary medicine clinic of The Royal London Hospital in the Whitechapel section of London. 50% had also used EHC in the past. 23% had experienced at least 1 induced abortion. The reasons for EHC use were contraceptive failure for 100 (66%) women, unprotected sexual intercourse for 48 (32%) women, and rape for 2 women. 93% of the women reporting contraceptive failure were using a condom during the index sexual intercourse. The remaining women recognized the possibility of failure of their oral contraceptives (e.g., concurrent use of an antibiotic and forgotten pill). 50 (33%) and 21 (14%) women returned to the clinic for follow-up within 1 month and 1-3 months of initial presentation, respectively. Nine of these women had attended the family planning advisory clinic. 3.3% of the 71 women who returned to the clinic were pregnant. 22 (31%) of the women who returned to the clinic reported side effects (10 nausea and vomiting, 9 nausea, 5 abdominal pain, 1 breast tenderness, and 1 a panic attack). More than 31% of returning women reported an abnormal period after using EHC. 51% of returning women said that their preferred future method of contraception would be condoms. 10% either had not yet decided to use contraception or were planning to become pregnant. Clinic staff screened only 13% of all 150 women for sexually transmitted diseases (STDs) within 1 month of unprotected intercourse. None of them had an STD. Six of the 150 women returned for a second EHC prescription within 3 months. These findings indicate the need for clinicians to address future contraceptive plans at the time of EHC prescription, since most women did not return for follow-up or family planning advice. They should also screen for STDs during this initial contact considering the high rate of unprotected intercourse. PMID:8707328

  11. Review of the combined contraceptive vaginal ring, NuvaRing®

    PubMed Central

    Roumen, Frans JME

    2008-01-01

    The purpose of this review was to test contraceptive efficacy, cycle control, tolerability, and acceptability as found in the non-comparative studies with NuvaRing® by those found in the randomized trials comparing NuvaRing and combined oral contraceptives (COCs). All large non-comparative studies and all relevant randomized controlled trials (RCTs) between NuvaRing and a COC up to and including December 2006 were analyzed. Two large multi-center registration studies, 1 large daily clinical practice study, and 6 RCTs comparing NuvaRing and a COC were identified. The findings in the non-comparative studies were confirmed in the RCTs. Contraceptive efficacy was high showing no significant differences in comparison with the COC; cycle control was good and consistently better than that of the COC; compliance was high and comparable with that of the pill; the incidence of adverse events such as breast tenderness, headache, and nausea was low, but not lower than with the COC despite a halving of the systemic exposure to ethinyl estradiol (EE) with NuvaRing compared with a 30-?g EE-containing COC; the incidence of local and ring-related events was low but higher than with the COC, leading to higher discontinuation rates among NuvaRing users; acceptability was high and comparable between both contraceptives, resulting in a global improvement of sexual function with both methods. After study completion, women using NuvaRing were more likely to continue with their method than women using a COC. The good results with respect to contraceptive efficacy, cycle control, tolerability, and acceptability as achieved with NuvaRing in the large non-comparative registration studies were confirmed in the RCTs comparing NuvaRing with different COCs. PMID:18728840

  12. Clinical guidelines on contraception and diabetes.

    PubMed

    Gupta, S

    1997-09-01

    Diabetic women present an interesting challenge to the reproductive health-care physician and gynecologist. Good preconceptual counselling reduces the risk of adverse consequences of the pregnancy to the mother and the fetus and should be encouraged. Poor metabolic control has been linked with an increased risk of congenital malformations. The low-dose combined pill (COC) does not appear to increase the risk of diabetes in women with a history of gestational diabetes. Young healthy diabetic women under 25 years old may be prescribed the low-dose COC with careful metabolic monitoring. The copper intrauterine contraceptive device is a useful choice in diabetic women with vascular disease, proliferative retinopathy and nephropathy. The progestogen-only pill and barrier methods may sometimes have unacceptable failure rates in diabetic women who may require to avoid a pregnancy at any cost. When a couple's family is complete, sterilization and vasectomy should be encouraged. PMID:9678088

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

    PubMed Central

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

    2014-01-01

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

  14. Twenty-seven Strategies for Teaching Contraception to Adolescents.

    ERIC Educational Resources Information Center

    Chesler, Joan

    1980-01-01

    Research on the effects of education on adolescents' contraceptive behaviors is summarized and 27 teaching strategies, each related to a particular contraceptive problem adolescents encounter, are outlined. (JMF)

  15. 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

  16. Contraceptive choices for perimenopausal women.

    PubMed

    Maddox, M A

    1993-01-01

    Ovulation begins to decline between the ages of 38 and 42 years accompanied by the decrease in circulating levels of estrogen. In a pilot study of 75 mid-life women at a large mid-Atlantic medical center, women were divided into 2 groups: those aged 45 through 49 years and those aged 50 through 55 years. In the study, 31 of the 75 women were already menopausal. The diaphragm was the major method used among the 65.3% of women using birth control, but its use by perimenopausal women is questionable, as a diaphragm may not fit as tightly as it had previously. Condoms with foams were found to be the second most frequent contraceptive method used. Condoms and foam may be the most functional method of birth control for the perimenopausal woman, as foam can be a lubricating source alleviating any dyspareunia. Condoms may be unpopular with older men already experiencing decreasing penile sensitivity. IUD use is limited, although 4 women continued to use either the hormone IUD, Progestaset, or the newer copper T-IUD. The major side effect has been the development of pelvic inflammatory disease possibly resulting in infertility. The IUD is contraindicated if the woman has experienced menorrhagia, uterine fibroids, or previous cervical surgery. The device has to be removed prior to the true menopausal state to prevent the IUD from becoming embedded in the uterine wall. Although the use of oral contraceptives by perimenopausal women remains controversial, 3 women in the study were taking them. If the woman does not smoke, is not obese, and is considered healthy, oral contraceptives containing 50 mcg estrogen have been shown to be safe for older women and without significant link to cardiovascular mortality. Oral contraceptives also can reestablish a regular menstrual cycle, prevent menopausal symptoms, and retard osteoporosis. Abstinence may prove a viable method. Nurse practitioners can also present the pros and cons of hormone replacement therapy and help women choose appropriate contraceptive methods during the perimenopausal years. PMID:8398428

  17. The first abortion - and the last? A study of the personality factors underlying repeated failure of contraception.

    PubMed

    Niemelä, P; Lehtinen, P; Rauramo, L; Hermansson, R; Karjalainen, R; Mäki, H; Storå, C A

    1981-06-01

    The causes leading to a second abortion were outlined in a psychological study comparing 30 women expecting a second abortion with 29 women who had successfully prevented conception after a first abortion. It was found that both groups improved their contraceptive practices after the first abortion. However, while the latter group continued with their improved practices, the former group went back to the earlier inefficient or non-existent contraceptive behavior. The inability to improve contraception in the long run was not related to differences in educational level or knowledge about contraceptive techniques but to the developmental level of personality structures. The women expecting their second abortion rated lower in control of impulsivity, emotional balance, realism, self-esteem and stability of life as well as capacity for more integrated personal relationships. The differences in personality development and consequently in the capacity for long-term contraception were found to be due to growth conditions in childhood. PMID:6120865

  18. 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

  19. Monitoring contraceptive continuation: links to fertility outcomes and quality of care.

    PubMed

    Blanc, Ann K; Curtis, Siân L; Croft, Trevor N

    2002-06-01

    This study examines the fertility consequences of contraceptive discontinuation, describes cross-national variation in continuation rates, and assesses the usefulness of the contraceptive discontinuation rate as a summary outcome indicator of quality of care. In the 15 countries included in this analysis, the total fertility rate would be between 28 and 64 percent lower if the births following discontinuations that were not the result of a desire to become pregnant had not occurred. The all-method discontinuation rate for quality-related reasons emerges as the most likely candidate for a summary measure of quality of care. Within a year of starting use of a method, between 7 and 27 percent of women cease to practice contraception for reasons related to the quality of the service environment. The results imply that as fertility declines, family planning programs would profit from a shift in emphasis from providing methods to new clients toward providing services to reduce discontinuation rates. PMID:12132634

  20. Contraceptive knowledge, attitudes, and practice in Russia during the 1980s.

    PubMed

    Popov, A A; Visser, A P; Ketting, E

    1993-01-01

    In the former Soviet Union, there was a lack of valid and reliable social research on knowledge, attitudes, and practice of contraception. The few available studies have not been published outside the Soviet Union. This article reviews five surveys that were conducted in Moscow and two other cities (Saratov and Tartu) during the period 1976-84. In addition, some data from a large-scale survey conducted in 1990 and covering the entire former Soviet Union are presented. The surveys indicate that the rhythm method, condoms, vaginal douches, and withdrawal were the main contraceptive methods used; only 1 to 3 percent of the women interviewed were using oral contraceptives, and about 10 percent used intrauterine devices. The low prevalence of use of reliable modern methods may explain the high incidence of induced abortion in Russia. The chronic unavailability of reliable contraceptives is one of the main factors of poor family planning. Lack of knowledge and negative opinions about modern contraception also play an important role. Some possibilities for improving the family planning situation in Russia are discussed. PMID:8212092

  1. 2012 Women's Contraceptive Drugs and Devices List

    E-print Network

    Buehrer, R. Michael

    2012 Women's Contraceptive Drugs and Devices List Aetna Student Health PlansSM Quality health plans as the health care reform law, will comply with requirements for Women's Preventive Health Services. This means that for women with reproductive capacity, certain women's contraceptive drugs and devices approved by the U

  2. Oral contraceptives and the risk of cancer

    Microsoft Academic Search

    Selvaraj S; Angus V; Iversen L

    2008-01-01

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

  3. Non-insulin-dependent diabetes in Kuwait: prevalence rates and associated risk factors 1 Poster presentation at 16th International Diabetes Federation Congress Helsinki, Finland, July 1997. 1

    Microsoft Academic Search

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

    1998-01-01

    Non-insulin-dependent diabetes mellitus (NIDDM) is a major clinical and public health problem in Kuwait. The objective of the study was to determine prevalence rates of NIDDM among a representative sample of the Kuwaiti adult population aged 20 and older in two out of five governorates and identify the associated risk factors for the disease. A total of 3003 subjects (1105

  4. Growth rates and the prevalence and progression of scoliosis in short-statured children on Australian growth hormone treatment programmes

    PubMed Central

    Day, Gregory A; McPhee, Ian Bruce; Batch, Jenny; Tomlinson, Francis H

    2007-01-01

    Study design and aim This was a longitudinal chart review of a diverse group (cohort) of patients undergoing HGH (Human Growth Hormone) treatment. Clinical and radiological examinations were performed with the aim to identify the presence and progression of scoliosis. Methods and cohort 185 patients were recruited and a database incorporating the age at commencement, dose and frequency of growth hormone treatment and growth charts was compiled from their Medical Records. The presence of any known syndrome and the clinical presence of scoliosis were included for analysis. Subsequently, skeletally immature patients identified with scoliosis were followed up over a period of a minimum four years and the radiologic type, progression and severity (Cobb angle) of scoliosis were recorded. Results Four (3.6%) of the 109 with idiopathic short stature or hormone deficiency had idiopathic scoliosis (within normal limits for a control population) and scoliosis progression was not prospectively observed. 13 (28.8%) of 45 with Turner syndrome had scoliosis radiologically similar to idiopathic scoliosis. 11 (48%) of 23 with varying syndromes, had scoliosis. In the entire cohort, the growth rates of those with and without scoliosis were not statistically different and HGH treatment was not ceased because of progression of scoliosis. Conclusion In this study, there was no evidence of HGH treatment being responsible for progression of scoliosis in a small number of non-syndromic patients (four). An incidental finding was that scoliosis, similar to the idiopathic type, appears to be more prevalent in Turner syndrome than previously believed. PMID:17316422

  5. 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

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

    PubMed Central

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

    2013-01-01

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

  7. Combined hormonal contraceptives and venous thromboembolism: putting the risks into perspective.

    PubMed

    Raymond, Elizabeth G; Burke, Anne E; Espey, Eve

    2012-05-01

    To date, 13 studies have provided data on the risk of venous thromboembolism associated with combined oral contraceptives containing drospirenone or the norelgestromin-containing contraceptive patch. The studies varied in their conclusions about whether these methods are associated with higher risks than combined oral contraceptives containing other progestins: the primary reported measures of association (adjusted odds ratios, incidence rate ratios, or hazard ratios) ranged from 0.9 to 3.3. All of the studies had weaknesses in population selection, data validity or completeness, or analysis that may have led to biased or spurious findings. Venous thromboembolism is rare; if the contraceptive methods of interest do confer a higher risk of thromboembolism, only an additional 5-10 per 10,000 users per year would be affected. The important message for patients, clinicians, and policy makers is that the benefits of all contraceptive methods markedly outweigh their risks, primarily because they prevent pregnancy, an inherently hazardous condition. Product labels for hormonal contraceptives should emphasize their substantial health benefits and established safety. PMID:22525916

  8. Efficacy of Combined Contraceptive Vaginal Ring Versus Oral Contraceptive Pills in Achieving Hypothalamic-Pituitary-Ovarian Axis Suppression in Egg Donor In Vitro Fertilization Cycles

    PubMed Central

    Thomas, Robin Lynn; Halvorson, Lisa Marie; Carr, Bruce Richard; Doody, Kathleen Marie; Doody, Kevin John

    2013-01-01

    Background Our study compares the efficacy of the combined contraceptive vaginal ring to oral contraceptive pills (OCPs) for hypothalamic-pituitary-ovarian (HPO) axis suppression in egg donor in vitro fertilization (IVF) cycles. Methods Our retrospective cohort study includes patients from the Center for Assisted Reproduction (CARE) in Bedford, Texas undergoing IVF cycles as egg donors from January 2003 through December 2009. Twenty-five and thirty-nine women were treated with OCPs and the combined contraceptive vaginal ring, respectively. Statistical analyses were performed using the SigmaStat Software package (Systat, Chicago, IL). Data were analyzed by t or Mann-whitney test and Chi-square of Fisher exact test. Statistical significance was set at p<0.05. Results Prior to gonadotropin initiation, endometrial thickness and serum estradiol were 5.6±2.6 mm and 33.6±19.9 pg/ml in the OCP group and 6.0±2.4 mm and 36.6±24.3 pg/ml in the combined contraceptive vaginal ring group, respectively (p=0.49 and p=0.33). Average serum FSH and LH were 1.7±1.9 and 1.7±2.5 mIU/ml in the OCP group and 1.7±1.6 and 1.2±1.4 mIU/ml in the combined contraceptive vaginal ring group, respectively (p=0.45 and p=0.95). No significant differences were found for gonadotropin requirement, peak estradiol, maximal endometrial thickness, number of oocytes retrieved, number of normally fertilized embryos, number of cryopreserved embryos, or live birth rates. Conclusion The combined contraceptive vaginal ring is effective for HPO axis suppression in egg donor IVF cycles and associated with cycle characteristics similar to those observed with OCP treatment. The combined contraceptive vaginal ring may provide an important advantage over OCPs due to improved patient compliance. PMID:24551576

  9. Measuring Contraceptive Use Patterns Among Teenage and Adult Women

    Microsoft Academic Search

    Dana A. Glei

    1999-01-01

    unintended pregnancy associated with patterns of long-term contraceptive use. Moreover, no studies of long-term con- traceptive use have compared teenagers and adult women. Given these limits, it is all the more trou- bling that researchers seldom validate measures of contraceptive use. With the exception of contraceptive failure analy- ses, studies often assess risk factors relat- ed to poor contraceptive use,

  10. 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…

  11. Decreased maximal aerobic capacity with use of a triphasic oral contraceptive in highly active women: a randomised controlled trial

    PubMed Central

    Lebrun, C; Petit, M; McKenzie, D; Taunton, J; Prior, J

    2003-01-01

    Background: Oral contraceptives are commonly used by women athletes. However, their effect on athletic performance is unclear. Objectives: To examine the effects of a moderate dose, triphasic oral contraceptive on measures of athletic performance in highly trained women athletes. Methods: This is a double blind, placebo controlled trial in 14 women with ovulatory menstrual cycles and maximal aerobic capacity (VO2MAX) ?50 ml/kg/min. Four measures of athletic performance were tested: VO2MAX, anaerobic capacity (anaerobic speed test), aerobic endurance (time to fatigue at 90% of VO2MAX), and isokinetic strength (Cybex II dynamometer). Height, weight, and six skinfold measurements were also recorded. All these observational tests were completed during both the follicular and mid-luteal phases of an ovulatory menstrual cycle. Cycle phases were confirmed by assaying plasma oestradiol and progesterone. Participants were subsequently randomly assigned to either a tricyclic oral contraceptive or placebo and retested in identical fashion (oral contraceptive phase). Results: Absolute and relative changes in VO2MAX from follicular to oral contraceptive phase decreased in the oral contraceptive group by 4.7%, whereas the placebo group showed a slight increase (+1.5%) over the same time period. Two of the women taking oral contraceptive had decreases of 4 and 9 ml/kg/min. In contrast, most women in the placebo group improved or maintained VO2MAX. There was also a significant increase in the sum of skinfolds in women taking oral contraceptive compared with those taking placebo (p<0.01). There were no significant changes in other physiological variables (maximum ventilation, heart rate, respiratory exchange ratio, packed cell volume) or measures of performance (anaerobic speed test, aerobic endurance, isokinetic strength) as a function of oral contraceptive treatment. Conclusions: The decrease in VO2MAX that occurs when oral contraceptive is taken may influence elite sporting performance in some women. Further studies are required to determine the mechanisms of this change. PMID:12893716

  12. Adolescent contraception: review and guidance for pediatric clinicians.

    PubMed

    Potter, J; Santelli, J S

    2015-03-01

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

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

    Microsoft Academic Search

    Margareta Hellgren; Peter J. Svensson; Björn Dahlbäch

    1995-01-01

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

  15. Students’ Perceptions of Contraceptives in University of Ghana

    PubMed Central

    Kayi, Esinam Afi

    2013-01-01

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

  16. 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

  17. 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

  18. 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

  19. 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 21–45 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

  20. 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

  1. Does choice make a difference to contraceptive use? Evidence from east Java.

    PubMed

    Pariani, S; Heer, D M; Van Arsdol, M D

    1991-01-01

    This study investigates sustained use of contraceptives among women in East Java, Indonesia. Interest is focused on the effect of whether the client's choice of contraceptive method was granted or denied, and the interaction between whether choice was granted or denied and husband-wife concurrence concerning method choice. Data were collected twice in a panel survey. The first round was conducted in family planning clinics among women initiating contraceptive use; the second was a follow-up household survey carried out 12 months later. Whether the user was granted her choice of method was found to be a very important determinant of sustained use of contraceptives. The interaction between whether choice was granted and whether there was husband-wife concurrence on method choice was also important. The highest rate of discontinuation occurred when method choice was denied in the presence of husband-wife agreement on method choice, and the lowest rate occurred when method choice was granted in the presence of such concurrence. The results imply that contraceptive continuation can be enhanced either when family planning workers pay more attention to the stated desires of their clients, or when policy is instituted allowing clients to use their method of choice. PMID:1792678

  2. Effects of low-dose oral contraceptives on female whole saliva.

    PubMed

    Laine, M; Pienihäkkinen, K; Ojanotko-Harri, A; Tenovuo, J

    1991-01-01

    The composition and flow rate of paraffin-stimulated whole saliva were analysed in 22 women, of whom 11 used oral contraceptives and 11 did not. Ten men served as the controls. The salivary samples were collected during one month (oral contraceptive users and men), or during one menstrual cycle (non-users). The saliva analyses included flow rate, pH, buffer effect, sialic acid, thiocyanate, peroxidase, lysozyme, amylase, immunoglobulins A, G and M, total protein, mutans streptococci, lactobacilli, yeasts and total numbers of aerobic bacteria. The salivary buffer effect of oral contraceptive users was significantly (p less than 0.005) higher than that of non-users. All the other constituents showed intra- and interindividual variation in all groups, but with no apparent hormone-dependency. PMID:1837983

  3. A new way to distribute contraceptives.

    PubMed

    1994-12-01

    In Beijing the Lotus Restaurant has shifted from providing toothpicks and fans as souvenirs to contraceptives and the message of "Special Love for Joyful Families." The State Minister of Family Planning has commended this practice. The restaurant has decorated the walls and ceiling with banners stating that one should never forget family planning when enjoying oneself. Table decorations include all types of contraceptives and pamphlets about healthier childbirth and child rearing. The general manager is responsible for this change. The restaurant is a joint venture of the Huajin Development Corporation of the International Economic Commission of the Western District of Beijing and the China Population Counseling Service Center and the Thai Association for Population and Social Development. The restaurant has provided over 6000 packs of contraceptives to adults since its initiation. Services are also available for counseling on contraceptives, healthier births, improved child rearing and education of children, and sex education. PMID:12290501

  4. [Adolescence and choice of contraceptive].

    PubMed

    Theunissen, L

    1986-11-01

    The majority of books, studies, and publications on adolescence are written by adults, whose frequent focus on unbridled adolescent sexuality, adolescents in crisis, or immature adolescents does not seem to correspond to the self-image of adolescents. All authors agree that adolescence is the period between childhood and adulthood beginning at puberty, but opinions differ as to the termination of adolescence and entrance into adulthood. The most significant consensus about adolescence is its tendency to become prolonged. The majority of authors regard adolescence as a preparation for adult life and hence as a natural phase necessary and indispensable to human existence. Ethnographic studies of societies that do not acknowledge adolescence demonstrate, however, that it is not a natural phase. It is also evident that comparatively few roles in modern society require lengthy periods of preparation such as adolescence. It is therefore difficult to regard adolescence as a time of preparation for adult life. From a historic perspective, adolescence emerged with the socioeconomic transformations of industrialization. Mechanization and automation excluded numerous types of workers, especially young workers, from the labor force. Adolescence represents marginalization of young people in response to socioeconomic exigencies rather than a period of preparation for a better adult life. The marginalization is internalized in the consciousness of adults and youth alike and in their hierarchical relations. The marginalization of young people is expressed in the domain of sexuality by the fact that, although physiologically mature, adolescents are not viewed as psychologically mature enough to have children. Adolescents have sexual relations at increasingly young ages, but unlike adults they are not permitted by society the choice of having a child. Contraception, an option for adults, becomes obligatory for sexually active adolescents. The refusal of contraception or failure to use it correctly on the part of some adolescents may be signs of rebellion against this constraint on their sexuality. PMID:12269089

  5. Prevalence rates of drug use among school bullies and victims: A systematic review and meta-analysis of cross-sectional studies

    E-print Network

    Valdebenito, Sara; Ttofi, Maria; Eisner, Manuel

    2015-05-20

    -involved individuals; however, prevalence rates are higher for perpetrators than victims of school bullying. For instance, Radliff et al., (2012) concluded that 11.4% of bullies reported marijuana use, compared with only 2% of victims and 1% of non- 5 involved... ), or softer drugs such as marijuana/cannabis (e.g., Liang, Flisher, & Lombard, 2007). Studies reporting on combined measures of alcohol or cigarette use plus drugs (e.g., Carlyle & Steinman, 2007) were excluded. Similarly, studies reporting on other...

  6. Ulipristal acetate: the newest emergency contraceptive.

    PubMed

    Wilton, Jeanne M

    2012-01-01

    More than 50 percent of pregnancies in the United States are unplanned. Emergency contraception has been shown to possibly reduce the risk of pregnancy by as much as 75 percent. Ulipristal acetate is a selective progesterone receptor modulator that was approved by the U.S. Food and Drug Administration (FDA) for emergency contraceptive use in August 2010. This article reviews information on its mechanism of action, efficacy, safety and implications for women's health nurses. PMID:22900810

  7. 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

    2014-11-10

    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

  8. Provision of injectable contraceptives in Ethiopia through community-based reproductive health agents

    PubMed Central

    Gessessew, Amanuel; Cartwright, Alice; Fraser, Ashley

    2011-01-01

    Abstract Objective To determine whether community-based health workers in a rural region of Ethiopia can provide injectable contraceptives to women with similar levels of safety, effectiveness and acceptability as health extension workers (HEWs). Methods This was a prospective non-randomized community intervention trial designed to test the provision of injectable contraceptives by community-based reproductive health agents (CBRHAs). Effectiveness, safety, acceptability and continuation rates were the outcomes of interest. The outcomes observed when injectable contraceptives were administered by HEWs in health posts and when they were administered by CBRHAs were compared by means of ?2 tests for association among categorical variables and t-tests for independent samples to determine differences between group means. Findings A total of 1062 women participated in the study. Compared with health post clients, the clients of CBRHAs were, on average, slightly older, less likely to be married and less educated, and they had significantly more living children. Women seeking services from CBRHAs were also significantly more likely to be using injectable contraceptives for the first time; health post clients were more likely to have used them in the past. In addition, clients of CBRHAs were less likely to discontinue using injectable contraceptives over three injection cycles than health post clients. Conclusion Receiving injectable contraceptives from CBRHAs proved as safe and acceptable to this sample of Ethiopian women as receiving them in health posts from HEWs. These findings add to the growing body of evidence supporting the development, introduction and scale up of programmes to train community-based health workers such as CBRHAs to safely administer injectable contraceptives. PMID:21836754

  9. 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

  10. Emergency contraception: past, present and future.

    PubMed

    Cremer, M; Masch, R

    2010-08-01

    Women have been using emergency contraception (EC) for decades. Population studies have not shown that increased access to EC decreases abortion rates this is likely because of inconsistent and infrequent use even when it is available. Special populations, such as adolescents, have been shown to be just as good as their adult counterparts in comprehending EC instructions, and its use does not lead to more risky sexual practices or behaviors. There is little evidence on the administration of EC to victims of sexual assault, but what is available reveals more women who are victims of sexual assault should be offered EC as an option. Methods of EC include high doses of ethinyl estradiol; DES; Danzaol; combination ethinyl estradiol with a progestin; progestin alone and copper IUDs. This review describes the history of EC as well as newer medications such as the antiprogestins (gestrinone and uliprisatal acetate) and cyclooxygenase inhibitors(meloxifam). These methods have been added to the armamentarium and may prove to be more effective than current regimens. Finding a product that is highly effective with minimal side effects is a worthy goal, for it presents a woman with her last chance to prevent an unwanted pregnancy. PMID:20827252

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

    PubMed Central

    Payne, N.; Saul, C.

    1997-01-01

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

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

    PubMed

    Williams, Rebekah L; Fortenberry, J Dennis

    2013-04-01

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

  13. 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

  14. 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.

  15. Factors predicting mood changes in oral contraceptive pill users

    PubMed Central

    2013-01-01

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

  16. [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

  17. [Contraception and adolescents, Rhone-Alpes, 1990].

    PubMed

    Picod-bernard, C; Levy, J; Samson, J M

    1991-11-01

    173 male and 181 female students of a secondary school in the region of Lyons, France, answered a questionnaire in late 1989 on their sexual and contraceptive attitudes and behavior. 76% of the respondents were French, 8% were Algerian, 3% were Portuguese, and the remainder were from various other countries. 16% were 16 years old or less, 32% were 17, 43% were 18-20, and 9% were 20 or over. Only 1 respondent was married. 49.2% were sexually active and their 1st sexual relations occurred on average at 15-16 years of age. Males reported earlier and more frequent sexual activity than females. In the previous year, 47.7% of sexually active respondents reported that they or their partners had used oral contraceptives, 33.3% condoms, .4% withdrawal, 21.3% rhythm, 5.6% spermicides, and 1% diaphragm. 33.6% reported using contraception regularly, 54.5% sporadically, and 11.9% never. Males were significantly less likely to report use of the more effective methods. Effective contraception was not significantly correlated with age of the respondents, age at 1st sexual experience, the sexual experience of friends, the number of partners, or the frequency of intercourse. Neither was there a correlation between effective contraception and the degree of religiosity, sexual permissiveness, or egalitarian attitudes. Attitudes of parents were correlated significantly though weakly with effective use of contraception. Age was significantly correlated with use of condoms, as were use by friends and approval of partners. The principal sources of information were peers for 50% and parents for 35%. Effective use of contraception and use of condoms appeared to be determined by somewhat different social factors, a finding of relevance for AIDS prevention programs. PMID:12284762

  18. 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

  19. Trends in Incidence Rates during 1999-2008 and Prevalence in 2008 of Childhood Type 1 Diabetes Mellitus in GERMANY – Model-Based National Estimates

    PubMed Central

    Kiess, Wieland; Kapellen, Thomas Michael; Stange, Thoralf; Manuwald, Ulf; Salzsieder, Eckhard; Holl, Reinhard Walter; Schoffer, Olaf; Stahl-Pehe, Anna; Giani, Guido; Ehehalt, Stefan; Neu, Andreas; Rosenbauer, Joachim

    2015-01-01

    Aims To estimate the national incidence rate and trend of type 1 diabetes (T1DM) in Germany from 1999 to 2008 and the national prevalence in 2008 in the age group 0–14 years. Methods Data were taken from a nationwide registry for incident cases of T1DM in the ages 0–4 years and 3 regional registries (North-Rhine-Westphalia, Baden-Wuerttemberg and Saxony) for incident cases of T1DM in the ages 0–14 years covering 41% of the child population in Germany. The degree of ascertainment was ? 97% in all registries. Incident and prevalent cases were grouped by region, sex, age (0–4, 5–9, 10–14 years), and, for incident data, additionally by two 5-year periods (1999–2003, 2004–2008). Poisson regression models were fitted to the data to derive national estimates of incidence rate trends and prevalence in the age groups 5–9, 10–14 and 0–14 years. We used direct age-standardization. Results The estimated national incidence rate in 0-14-year-olds increased significantly by 18.1% (95%CI: 11.6–25.0%, p<0.001) from 1999–2003 to 2004–2008, independent of sex, corresponding to an average annual increase of 3.4% (95%-CI: 2.2–4.6%). The overall incidence rate was estimated at 22.9 per 100,000 person-years and we identified a within-country west-east-gradient previously unknown. The national prevalence in the ages 0–14 years on 31/12/2008 was estimated to be 148.1 per 100,000 persons. Conclusions The national incidence rate of childhood T1DM in Germany is higher than in many other countries around the world. Importantly, the estimated trend of the incidence rate confirms the international data of a global increase of T1DM incidences. PMID:26181330

  20. No more periods? Oral contraception and menstrual suppression 

    E-print Network

    Gunson, Dr Jessie

    Oral contraception, or ‘The Pill’, is widely used by women to control how often they have a period. In many countries using oral contraception in this way has remained unofficial practice. However, in 2003 the first FDA ...

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

    ERIC Educational Resources Information Center

    Terry, Elizabeth; Manlove, Jennifer

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

  2. New estimates of the effectiveness of the Yuzpe regimen of emergency contraception

    Microsoft Academic Search

    James Trussell; Germán Rodr??guez; Charlotte Ellertson

    1998-01-01

    The purpose of this study was to provide new estimates of the effectiveness of the Yuzpe method of emergency contraception and to offer correctly computed estimates of the confidence intervals for estimated effectiveness rates.Through a literature search, seven studies that present the number of women treated and outcome of treatment by cycle day of unprotected intercourse relative to expected day

  3. Age, parity, history of abortion and contraceptive choices affect the risk of repeat abortion

    Microsoft Academic Search

    Oskari Heikinheimo; Mika Gissler; Satu Suhonen

    2008-01-01

    BackgroundThe rate of repeat induced abortion varies from 30% to 38% in northern Europe. Thus, repeat abortion is an important public health issue. However, risk factors as regards repeat abortion are poorly understood. We characterized risk factors related to sociodemographic characteristics, history of abortion and post-abortal contraception.

  4. Communication, Contraception and Culture: A Semiotic Analysis of Educational Materials for Latinas

    Microsoft Academic Search

    Maia M. Mercer

    2012-01-01

    Unintended pregnancy is a major problem in the United States, especially for some minority populations. Latina women have higher birth rates and lower use of contraception than the general population. The health care system should support Latinas in meeting their health and family planning needs. Cultural differences require taking into account social values and the communication needs and patterns of

  5. Contraceptive Use Among Adolescent Latinas Living in the United States: The Impact of Culture and Acculturation

    Microsoft Academic Search

    Sandra P. Sterling; Lois S. Sadler

    2009-01-01

    Although adolescent pregnancies have declined steadily during the past decade, Latina adolescents continue to have disproportionately high pregnancy rates. For nurse practitioners to effectively counsel this group of women concerning contraceptive use and sexual health, a basic understanding of the unique sociocultural factors influencing Latina adolescents' sexual activity is important. This article reviews recent literature concerning the effects of culture,

  6. Emergency contraception -- mechanisms of action.

    PubMed

    Gemzell-Danielsson, Kristina; Berger, Cecilia; P G L, Lalitkumar

    2013-03-01

    Concerns regarding the mechanisms of action of emergency contraception (EC) create major barriers to widespread use and could also lead to incorrect use of EC and overestimation of its effectiveness. While the copper intrauterine device (Cu-IUD) is the most effective method available for EC, the hormonal methods are frequently considered to be more convenient and acceptable. Today, the most commonly used method for hormonal EC is levonorgestrel (LNG). More recently, the progesterone receptor modulator ulipristal acetate (UPA) has been shown to be more effective than LNG to prevent an unwanted pregnancy. The main mechanism of action of both LNG and UPA for EC is delaying or inhibiting ovulation. However, UPA appears to have a direct inhibitory effect on follicular rupture which allows it to be effective even when administered shortly before ovulation, a time period when use of LNG is no longer effective. The main mechanism of action of the Cu-IUD is to prevent fertilization through the effect of Cu ions on sperm function. In addition, if fertilization has already occurred, Cu ions influence the female reproductive tract and prevent endometrial receptivity. Based on this review of the published literature, it can be concluded that existing methods used today for EC act mainly through inhibition of ovulation or prevention of fertilization. An additional effect on the endometrium as occurs for the Cu-IUD, but not for the hormonal alternatives, seems to increase the efficacy of the method. PMID:23114735

  7. Gastrointestinal metabolism of contraceptive steroids.

    PubMed

    Back, D J; Madden, S; Orme, M L

    1990-12-01

    A number of oral contraceptive steroids undergo first-pass metabolism in the gastrointestinal mucosa. Ethinyl estradiol (mean systemic bioavailability 40% to 50%) is extensively metabolized, principally to a sulfate conjugate. In vivo studies that use portal vein catheterization and the administration of radiolabeled ethinyl estradiol have shown that the fraction of steroid metabolized in the gut wall is 0.44. In vitro studies with jejunal biopsy samples or larger pieces of jejunum or terminal ileum mounted in Ussing chambers have indicated that more than 30% of added ethinyl estradiol is sulfated. The progestogen desogestrel is a prodrug that is converted to the active metabolite 3-ketodesogestrel. Substantial first-pass metabolism of desogestrel occurs in the gut mucosa, with evidence from Ussing chamber studies for the formation of the active metabolite. Another progestogen, norgestimate, is also metabolized by the gut wall in vitro of which the principal metabolite is the deacetylated product, norgestrel oxime. It seems very likely that this will also occur in vivo. Drug interactions occurring in the gut wall have been reported with ascorbic acid (vitamin C) and paracetamol. PMID:2147818

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

    PubMed

    Hopkins, Craig

    2014-12-01

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

  9. Knowledge and Beliefs about Contraception in Urban Latina Women

    Microsoft Academic Search

    Pavithra Venkat; Rachel Masch; Eliza Ng; Miriam Cremer; Sue Richman; Alan Arslan

    2008-01-01

    Our study aimed to identify perceptions Latina women have about four different contraceptive methods and to investigate whether\\u000a religiosity and acculturation play a role in their contraceptive choice. An observational cross-sectional study was performed\\u000a at Bellevue Hospital. A questionnaire was given to women in the gynecology outpatient clinics asking about: oral contraceptive\\u000a pills (OCP’s), injectable contraception (DMPA), the Intrauterine device

  10. 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

  11. 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

  12. Challenging Oral Contraception after Weight Loss by Bariatric Surgery

    Microsoft Academic Search

    Zaher O. Merhi

    2007-01-01

    As surgical weight loss becomes more commonly performed in fertile women, adequate contraception is more frequently becoming an issue. The purpose of this article is to appraise the literature to ascertain whether the use of oral contraception is effective and adequate after bariatric surgery. The literature search revealed that the combination of lower oral contraception dosages and surgical gastrointestinal disturbances

  13. Emergency contraception: a “fire extinguisher” for unintended pregnancies

    Microsoft Academic Search

    Susan C. Farrar; Jon Yenari; Robert B. Gherman

    2003-01-01

    The American College of Obstetricians and Gynecologists defines emergency contraception, also known as post-coital contraception and the “morning after pill,” as “a therapy for women who experience an act of unprotected sexual intercourse.” It has been estimated that post-coital contraception could reduce the number of unintended pregnancies by 2 million and the number of induced abortions by 1 million. Several

  14. Advertising emergency contraception using local radio: an evaluation

    Microsoft Academic Search

    Christine Hall; Philip Milner

    1996-01-01

    Emergency contraception offers considerable potential for reducing un wanted pregnancies, yet knowledge about its availability and use remains poor. This paper describes a radio advertising campaign in Rotherham and surrounding areas to promote the use of emergency contraception. The effectiveness of the campaign was evaluated by comparing the prescribing of emergency contraception in the districts participating in the campaign with

  15. The effect of a contraceptive theme on response to erotica

    Microsoft Academic Search

    Christine Jazwinski; Donn Byrne

    1978-01-01

    Undergraduate students (60 males, 60 females) viewed a sexually explicit movie in which a couple engaged in intercourse. Different themes were introduced by prefacing the film with information varying the filmed couple's apparent marital status (single, married) and contraceptive practices (no information, no contraception, contraception via the pill). After viewing the movie, subjects filled out a questionnaire assessing their own

  16. HEALTH MATTERS Frequently Asked Questions About the Contraceptive Patch

    E-print Network

    Yener, Aylin

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

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

    PubMed

    2013-11-01

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

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

    PubMed Central

    Popham, Frank; Gray, Linsay; Bambra, Clare

    2012-01-01

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

  19. Applicability of the ICD-11 proposal for PTSD: a comparison of prevalence and comorbidity rates with the DSM-IV PTSD classification in two post-conflict samples

    PubMed Central

    Stammel, Nadine; Abbing, Eva M.; Heeke, Carina; Knaevelsrud, Christine

    2015-01-01

    Background The World Health Organization recently proposed significant changes to the posttraumatic stress disorder (PTSD) diagnostic criteria in the 11th edition of the International Classification of Diseases (ICD-11). Objective The present study investigated the impact of these changes in two different post-conflict samples. Method Prevalence and rates of concurrent depression and anxiety, socio-demographic characteristics, and indicators of clinical severity according to ICD-11 in 1,075 Cambodian and 453 Colombian civilians exposed to civil war and genocide were compared to those according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Results Results indicated significantly lower prevalence rates under the ICD-11 proposal (8.1% Cambodian sample and 44.4% Colombian sample) compared to the DSM-IV (11.2% Cambodian sample and 55.0% Colombian sample). Participants meeting a PTSD diagnosis only under the ICD-11 proposal had significantly lower rates of concurrent depression and a lower concurrent total score (depression and anxiety) compared to participants meeting only DSM-IV diagnostic criteria. There were no significant differences in socio-demographic characteristics and indicators of clinical severity between these two groups. Conclusions The lower prevalence of PTSD according to the ICD-11 proposal in our samples of persons exposed to a high number of traumatic events may counter criticism of previous PTSD classifications to overuse the PTSD diagnosis in populations exposed to extreme stressors. Also another goal, to better distinguish PTSD from comorbid disorders could be supported with our data. PMID:25989951

  20. Ulipristal acetate: a new emergency contraceptive.

    PubMed

    Sullivan, Jade L; Bulloch, Marilyn N

    2011-07-01

    Ulipristal acetate (UPA) is a newly developed emergency contraceptive currently available in the USA and Europe. It is approved as a 30 mg one-time dose taken within 120 h (5 days) of unprotected intercourse or failed contraception. This selective progesterone receptor modulator appears to be more effective than the levonorgestrel-containing emergency contraceptive, which must be taken within 72 h of unprotected intercourse. According to pharmacodynamic trials, UPA delays follicular maturation and ovulation. In addition, UPA may modulate the endometrium. Both Phase III clinical trials found that UPA does not lose efficacy within the 120-h dosing interval. Throughout all phases of clinical studies, UPA was shown to be well tolerated with only minimal adverse drug reactions, all of which are similar to competitor therapies. PMID:22114852

  1. Intravesical stone formation on intrauterine contraceptive device.

    PubMed

    Ozgür, Abdurrahman; Si?mano?lu, Alper; Yazici, Cenk; Co?ar, Emine; Tezen, Devrim; Ilker, Yalçin

    2004-01-01

    Since more than 30 years, intrauterine contraceptive devices (IUCD) have been used for a contraceptive opportunity. Although they are termed to be a safe and effective method for contraception, they also have some type of complications and uterine perforation, septic abortion, pelvic abscess are the serious complications of these devices. The incidence of uterine perforation is very low, but in the literature nearly 100 cases were reported about the extra uterine localization of IUCD. Migration may occur to the adjacent organs. We here in describe a case of a 31 year-old woman who had an IUCD with stone formation in the bladder. In the literature all of the cases were reported as IUCD migration, but although it seems technically impossible, IUCD placement into the bladder should also be considered in misplaced IUCDs. PMID:15783103

  2. Seasonality and prevalence rates of Steinina sp. (Eugregarinorida: Actinocephalidae) in Ctenocephalides felis felis (Siphonaptera: Pulicidae) from dogs captured in Belo Horizonte, Minas Gerais, Brazil.

    PubMed

    De Avelar, Daniel M; Linardi, Pedro M

    2008-11-01

    In total, 1500 specimens (448 males and 1052 females) of the flea Ctenocephalides felis felis (Bouché (Siphonaptera: Pulicidae) were collected over a period of a year from 150 dogs captured by the Centro de Controle de Zoonoses de Belo Horizonte, Minas Gerais, Brazil. Microscopic examination of the dissected fleas revealed that 180 fleas were infected with a species of gregarine that was subsequently identified as a member of the genus Steinina. The relative abundances, prevalence rates, and seasonal variation of the different developmental stages of this endoparasite in C. felis felis were determined. Both gamonts and gametocysts presented significant seasonal variation. PMID:19058639

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

    PubMed

    Moslin, Trisha A; Rochat, Roger W

    2011-08-01

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

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

    PubMed Central

    Abate, Meskerem; Assefa, Nega; Alemayehu, Tadesse

    2014-01-01

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

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

    PubMed Central

    2014-01-01

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

  6. 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

  7. Contraceptive use during lactation in developing countries.

    PubMed

    Pebley, A R; Goldberg, H I; Menken, J

    1985-01-01

    Contraceptive use by breastfeeding women in developing countries has led to concern about potentially harmful effects of steroid contraceptives on the health of breastfed children. In this paper, breastfeeding women's use of the pill and hormonal injections is investigated using survey data from 17 Latin American, Asian, and African countries. The results indicate that while the proportions of breastfeeding women who use these methods were small in most countries at the time of the surveys, the proportion using the pill was not inconsequential. In general, younger lactating women with higher education and more live births who live in urban areas are more likely to use the pill than other breastfeeding women. PMID:3983981

  8. Sexuality and Contraception for Developmentally Handicapped Persons

    PubMed Central

    MacLachlan, Richard; Peppin, Patricia

    1986-01-01

    Marked changes are occurring in the manner in which developmentally handicapped persons are being incorporated into society. These changes necessitate careful planning and review of the consequences of social interactions, including those of sexual development and fertility. Physicians and other health care workers should familiarize themselves with the current techniques of contraception as they apply to the developmentally handicapped and the current status of consent as it applies to therapeutic and non-therapeutic interventions, including advice about temporary and permanent contraception. PMID:21267114

  9. Hormonal contraceptives and travel to high altitude.

    PubMed

    Keyes, Linda E

    2015-03-01

    Women frequently ask about the safety and efficacy of using hormonal contraception (HC), either oral contraceptive pills (OC) or other forms, when traveling to high altitude locales. What are the risks and benefits of using HC at high altitude? Does HC affect acclimatization, exercise performance, or occurrence of acute mountain sickness? This article reviews current data regarding the risks and benefits of HC at high altitude, both demonstrated and theoretical, with the aim of helping health care providers to advise women traveling above 2500 meters. Most healthy women can safely use HC when traveling to high altitude, but should be aware of the potential risks and inconveniences. PMID:25759908

  10. Oral contraceptives and the risk of gallbladder disease: a comparative safety study

    PubMed Central

    Etminan, Mahyar; Delaney, Joseph A.C.; Bressler, Brian; Brophy, James M.

    2011-01-01

    Background Recent concerns have been raised about the risk of gallbladder disease associated with the use of drospirenone, a fourth-generation progestin used in oral contraceptives. We conducted a study to determine the magnitude of this risk compared with other formulations of oral contraceptives. Methods We conducted a retrospective cohort study using the IMS LifeLink Health Plan Claims Database. We included women who were using an oral contraceptive containing ethinyl estradiol combined with a progestin during 1997–2009. To be eligible, women had to have been taking the oral contraceptive continuously for at least six months. We computed adjusted rate ratios (RRs) for gallbladder disease using a Cox proportional hazards model. In the primary analysis, gallbladder disease was defined as cholecystectomy; in a secondary analysis, it was defined as hospital admission secondary to gallbladder disease. Results We included 2 721 014 women in the cohort, 27 087 of whom underwent surgical or laparoscopic cholecystectomy during the follow-up period. Compared with levonorgestrel, an older second-generation progestin, a small, statistically significant increase in the risk of gallbladder disease was associated with desogestrel (adjusted RR 1.05, 95% confidence interval [CI] 1.01–1.09), drospirenone (adjusted RR 1.20, 95% CI 1.16–1.26) and norethindrone (adjusted RR 1.10, 95% CI 1.06–1.14). No statistically significant increase in risk was associated with the other formulations of oral contraceptive (ethynodiol diacetate, norgestrel and norgestimate). Interpretation In a large cohort of women using oral contraceptives, we found a small, statistically significant increase in the risk of gallbladder disease associated with desogestrel, drospirenone and norethindrone compared with levonorgestrel. However, the small effect sizes compounded with the possibility of residual biases in this observational study make it unlikely that these differences are clinically significant. PMID:21502354

  11. Flagellated algae protein evolution suggests the prevalence of lineage-specific rules governing evolutionary rates of eukaryotic proteins.

    PubMed

    Chang, Ting-Yan; Liao, Ben-Yang

    2013-01-01

    Understanding the general rules governing the rate of protein evolution is fundamental to evolutionary biology. However, attempts to address this issue in yeasts and mammals have revealed considerable differences in the relative importance of determinants for protein evolutionary rates. This phenomenon was previously explained by the fact that yeasts and mammals are different in many cellular and genomic properties. Flagellated algae species have several cellular and genomic characteristics that are intermediate between yeasts and mammals. Using partial correlation analyses on the evolution of 6,921 orthologous proteins from Chlamydomonas reinhardtii and Volvox carteri, we examined factors influencing evolutionary rates of proteins in flagellated algae. Previous studies have shown that mRNA abundance and gene compactness are strong determinants for protein evolutionary rates in yeasts and mammals, respectively. We show that both factors also influence algae protein evolution with mRNA abundance having a larger impact than gene compactness on the rates of algae protein evolution. More importantly, among all the factors examined, coding sequence (CDS) length has the strongest (positive) correlation with protein evolutionary rates. This correlation between CDS length and the rates of protein evolution is not due to alignment-related issues or domain density. These results suggest no simple and universal rules governing protein evolutionary rates across different eukaryotic lineages. Instead, gene properties influence the rate of protein evolution in a lineage-specific manner. PMID:23563973

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

    ERIC Educational Resources Information Center

    Reaser, Joel M.; And Others

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

  13. Modelling strategic interventions in a population with a total fertility rate of 8.3: a cross-sectional study of Idjwi Island, DRC

    PubMed Central

    2012-01-01

    Background Idjwi, an island of approximately 220,000 people, is located in eastern DRC and functions semi-autonomously under the governance of two kings (mwamis). At more than 8 live births per woman, Idjwi has one of the highest total fertility rates (TFRs) in the world. Rapid population growth has led to widespread environmental degradation and food insecurity. Meanwhile family planning services are largely unavailable. Methods At the invitation of local leaders, we conducted a representative survey of 2,078 households in accordance with MEASURE DHS protocols, and performed ethnographic interviews and focus groups with key informants and vulnerable subpopulations. Modelling proximate determinates of fertility, we evaluated how the introduction of contraceptives and/or extended periods of breastfeeding could reduce the TFR. Results Over half of all women reported an unmet need for spacing or limiting births, and nearly 70% named a specific modern method of contraception they would prefer to use; pills (25.4%) and injectables (26.5%) were most desired. We predicted that an increased length of breastfeeding (from 10 to 21 months) or an increase in contraceptive prevalence (from 1% to 30%), or a combination of both could reduce TFR on Idjwi to 6, the average desired number of children. Increasing contraceptive prevalence to 15% could reduce unmet need for contraception by 8%. Conclusions To meet women’s need and desire for fertility control, we recommend adding family planning services at health centers with NGO support, pursuing a community health worker program, promoting extended breastfeeding, and implementing programs to end sexual- and gender-based violence toward women. PMID:23137304

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

    PubMed Central

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

    2009-01-01

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

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

    PubMed

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

    2014-09-01

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

  16. Prevalence of chronic kidney diseases in patients with chronic obstructive pulmonary disease: assessment based on glomerular filtration rate estimated from creatinine and cystatin C levels

    PubMed Central

    Yoshizawa, Takayuki; Okada, Kazuyoshi; Furuichi, Sachiko; Ishiguro, Toshihiko; Yoshizawa, Akitaka; Akahoshi, Toshiki; Gon, Yasuhiro; Akashiba, Tsuneto; Hosokawa, Yoshifumi; Hashimoto, Shu

    2015-01-01

    Background Cardiovascular diseases, osteoporosis, and depression are identified comorbidities of chronic obstructive pulmonary disease (COPD), but there have been few reports of chronic kidney disease (CKD) as a comorbidity of COPD. The objective of this study was to investigate the prevalence of CKD in COPD patients using estimated glomerular filtration rate (eGFR) based on creatinine (Cr) and cystatin C (Cys) levels. Methods The prevalence of CKD and the values of various CKD-related parameters were compared between 108 stable COPD outpatients (COPD group) and a non-COPD control group consisting of 73 patients aged 60 years or more without a history of COPD or kidney disease. CKD was defined as an eGFR less than 60 mL/min/1.73 m2. Results The Cr level was significantly higher in the COPD group, but eGFR based on serum Cr (eGFRCr) was not significantly different between the two groups (73.3±25.3 vs 79.7±15.5 mL/min/1.73 m2). The Cys level was significantly higher and eGFR based on serum Cys (eGFRCys) was significantly lower in the COPD group (60.0±19.4 vs 74.0±13.5 mL/min/1.73 m2, P<0.0001). The prevalence of CKD evaluated based on eGFRCr was 31% in the COPD group and 8% in the non-COPD group with an odds ratio of 4.91 (95% confidence interval, 1.94–12.46, P=0.0008), whereas the evaluated prevalence based on eGFRCys was 53% in the COPD group and 15% in the non-COPD group with an odds ratio of 6.30 (95% confidence interval, 2.99–13.26, P<0.0001), demonstrating a higher prevalence of CKD when based on eGFRCys rather than on eGFRCr. Conclusion CKD is a comorbidity that occurs frequently in COPD patients, and we believe that renal function in Japanese COPD patients should preferably be evaluated based not only on Cr but on Cr in combination with Cys. PMID:26185434

  17. Physiologic and psychologic symptoms associated with use of injectable contraception and 20 µg oral contraceptive pills

    PubMed Central

    Berenson, Abbey B.; Odom, Susan D.; Radecki Breitkopf, Carmen; Rahman, Mahbubur

    2013-01-01

    Objective To compare menstrual, physiologic, and psychologic symptoms over 2 years among women initiating use of depot medroxyprogesterone acetate or an oral contraceptive pill with a reduced pill-free interval, and those not using hormonal contraception. Methods A total of 608 women reported their experience regarding 17 symptoms prior to initiating contraception and every 6 months thereafter for 24 months. Longitudinal relationships between symptoms and contraceptives were assessed after adjusting for age, visits, and baseline status of symptoms. Results Oral contraceptive pills were protective against mastalgia (OR = 0.7), cramping (OR = 0.5), hair loss (OR = 0.6), acne (OR = 0.4), nervousness (OR = 0.5), and mood swings (OR = 0.7). DMPA was protective against bloating (OR = 0.5) and mood swings (OR = 0.7), but caused weight gain (OR = 2.3), bleeding episodes >20 days (OR = 13.4), and missed periods (OR = 96.9). Both methods caused intermenstrual bleeding. Conclusion Evidence-based data regarding beneficial and adverse symptoms associated with these methods may help clinicians counsel patients appropriately prior to contraceptive initiation. PMID:18599013

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

    PubMed

    Ettarh, Remare R; Kyobutungi, Catherine

    2012-09-01

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

  19. 'Organisation of contraceptive care' and attitudes among healthcare providers in two Swedish cities with different socio-demographic profiles.

    PubMed

    Palmquist, Moa; Brynhildsen, Jan; Falk, Gabriella

    2015-06-01

    Objective To compare contraceptive services provided by family planning clinics in Linköping and Norrköping in Östergötland County, Sweden. The two cities are of similar size but have different socio-demographic profiles. The abortion rate in Linköping (15.3 per 1000) is substantially lower than in Norrköping (21.1 per 1000). Methods The study was performed in two steps. First, the clinics providing contraceptive services in the two cities were studied using ten pre-defined quality indicators. Thereafter, 11 healthcare providers were interviewed: six in Linköping and five in Norrköping. The interviews were analysed using qualitative content analysis. Results No differences were found in the organisation of contraceptive care in the two cities. Neither city met the criteria for five of the ten quality indicators. The analysis of the interviews generated four themes: 'Guidelines and electronic record template', 'Criteria for good contraceptive counselling', 'Availability of contraception', and 'Sexual health'. The interviews revealed that the clinical leadership in Norrköping was insufficient. Conclusion Clinics in the two cities are organised in the same way so that differences in abortion rates cannot be related to differences in organisation. The reasons for the differences in abortion rates in the two cities have yet to be determined. Chinese Abstract östergötlandLinköpingNorröping ??-?Linköping15.3‰?Norröping 21.1‰?? ????11?6Linköping?5Norröping?? ??????Norröping?? ??. PMID:25428331

  20. Breast cancer detection rates, and standardised detection ratios for prevalence screening in the New Zealand breast cancer screening programme

    Microsoft Academic Search

    A Richardson; P Graham; T Brown; P Smale; B Cox

    2004-01-01

    Results: In 1999, the breast cancer detection rate was 5.6 per 1000 women screened. The expected incidence among these women in the absence of screening was 2.3 per 1000, a detection to expected incidence ratio of 2.4. The SDR was 0.84 (0.76- 0.94). In 2000, the breast cancer detection rate was 6.0 per 1000 women screened. The expected incidence among

  1. Estimating the effectiveness of emergency contraceptive pills

    Microsoft Academic Search

    James Trussell; Charlotte Ellertson; Helena von Hertzen; Allison Bigrigg; Anne Webb; Margaret Evans; Sue Ferden; Clare Leadbetter

    2003-01-01

    ObjectiveWe use new estimates of conception probabilities by cycle day of intercourse, where cycle day is measured with day 1 being the first day of bleeding in a cycle, to propose a new approach for estimating the effectiveness of emergency contraceptive pills (ECPs). We use this new approach to examine the absolute effectiveness and the cost-effectiveness of ECPs and whether

  2. Mechanisms of action of emergency contraception

    Microsoft Academic Search

    Horacio B. Croxatto; Mar??a E. Ortiz; Andrés L. Müller

    2003-01-01

    The use of levonorgestrel (LNG) alone or combined with ethinylestradiol (Yuzpe regimen), for hormonal emergency contraception (HEC) has been approved in several countries whereas in others it is still under debate or has been rejected under the claim that these formulations abort the developmental potential of the embryo. The issue is whether they act by preventing fertilization or by impeding

  3. [Abortifacient effect of hormonal contraceptives: a review].

    PubMed

    Agulles Simó, Pau

    2015-01-01

    Most of the scientific community, as well as in a sector of international Law, when referring to the unborn embryo, pregnancy must be defined as the period extending from implantation to natural birth. This implies some novelty, such as the redefinition of abortion as the elimination of the embryo only within this period, and the extension of contraception to any means that impedes the union of the gametes as a consequence of a sexual intercourse, or also that which eliminates the product of conception prior to its implantation. Therefore, the pharmaceutical industry markets, under the name of contraceptives, products that act also by means of an anti-implantation mechanism. This fact has great ethical implications regarding the respect for the embryo which require a reflection on the moral valuation of the prescription, dispensation and use of these means. One may ask: which of the contraceptive means actually present in the market include an anti-implantation effect? What mechanisms contribute to their pharmacological action and in what measure do they do this? This is what we have studied in this article, based on the available scientific bibliography. We have basically fulfilled a double objective: updating and completing the studies -few, partial or distant in time- that had this same subject matter; and offering a moral valuation on the use of hormonal contraceptives that may have an anti-implantation effect, from the point of view of the respect due to the embryonic life. PMID:26030015

  4. Use and knowledge of hormonal emergency contraception

    Microsoft Academic Search

    I. Virjo; A.-L. Kirkkola; M. Isokoski; K. Mattila

    1999-01-01

    Hormonal emergency contraception (EC) is an acceptable means of postcoital prevention of pregnancy, but potential users should have information and education about it before they need it. The aim of this study was to establish how many women and how many men's partners have used hormonal EC and how well the respondents know the correct time to take EC pills.

  5. Success with oral contraceptives: a pilot study

    Microsoft Academic Search

    Melissa Gilliam; Sara Knight; Martin McCarthy

    2004-01-01

    The objective of this pilot study was to examine the effectiveness of a postpartum educational intervention aimed at increasing compliance with oral contraception (OCs) and decreasing repeat pregnancies in young, African American women in the year following an unplanned pregnancy. In this longitudinal study, 43 young, pregnant women attending Prentice Ambulatory Care, Northwestern Hospital, were enrolled and 33 were randomized

  6. An Oral Contraceptive Drug Interaction Study

    ERIC Educational Resources Information Center

    Bradstreet, Thomas E.; Panebianco, Deborah L.

    2004-01-01

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

  7. Parental Involvement and Young Women's Contraceptive Use

    ERIC Educational Resources Information Center

    Frisco, Michelle L.

    2005-01-01

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

  8. Antibiotic interference with oral contraceptive steroid efficacy.

    PubMed

    Siew, C; Gruninger, S E; Burrell, K H

    1991-01-01

    Dentists prescribing antibiotics to women of childbearing age should be aware that current lower dosage oral contraceptives may fail and cause pregnancy, putting the practitioner at risk for damage claims. The most common antibiotics used in dental practice that may compromise oral contraceptive efficacy are penicillins, such as penicillin V, penicillin G, ampicillin, flucloxacillin, tolampicillin, amoxycillin and cloxacillin, and tetracyclines, such as tetracycline, oxytetracycline, doxycycline and chlortetracycline. Other common antibiotics include sulfonamides, erythromycin, metronidazole, griseofulvin and cephalosporins. The physiological basis for failure of the combined pill is loss of gut bacteria, and decreased enteric recycling of estrogen metabolites. The reason why progesterone-only pills may fail is unknown, and probably not related to drug interaction. Studies on blood levels of estrogens are conflicting; furthermore, it is impossible to predict which woman is at risk. Dentists should inform all women of childbearing age of possible failure of oral contraceptives. They should attempt to get an accurate drug history from female patients, and insert a signed copy in patients' record. It would be helpful to remind the pharmacist to label oral contraceptive prescription bottles with warnings about concurrent antibiotic usage. PMID:1886418

  9. Contraception and Women with Intellectual Disabilities

    ERIC Educational Resources Information Center

    McCarthy, Michelle

    2009-01-01

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

  10. Contraceptive Hormone Use and Cardiovascular Disease

    PubMed Central

    Shufelt, Chrisandra L.; Noel Bairey Merz, C.

    2009-01-01

    Contraceptive hormones, most commonly prescribed as oral contraceptives (OC), are a widely utilized method to prevent ovulation, implantation and therefore pregnancy. The Women’s Health Initiative demonstrated cardiovascular risk linked to menopausal hormone therapy among women without pre-existing cardiovascular disease, prompting review of the safety, efficacy and side effects of other forms of hormone therapy. A variety of basic science, animal and human data suggest that contraceptive hormones have anti-atheromatous effects, however relatively less is known regarding the impact on atherosclerosis, thrombosis, vasomotion and arrhythmogenesis. Newer generation OC formulations currently in use indicate no increased myocardial infarction (MI) risk for current users, but a persistent increased risk of venous thrombo-embolism (VTE). There are no cardiovascular data available for the newest generation contraceptive hormone formulations, including those that contain newer progestins that lower blood pressure, as well as the non-oral routes (topical and vaginal). Current guidelines indicate that, as with all medication, contraceptive hormones should be selected and initiated by weighing risks and benefits for the individual patient. Women 35 years and older should be assessed for cardiovascular risk factors including hypertension, smoking, diabetes, nephropathy and other vascular diseases including migraines, prior to use. Existing data are mixed with regard to possible protection from OC for atherosclerosis and cardiovascular events; longer-term cardiovascular follow-up of menopausal women with regard to prior OC use, including subgroup information regarding adequacy of ovulatory cycling, the presence of hyperandrogenic conditions, and the presence of prothrombotic genetic disorders is needed to address this important issue. PMID:19147038

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

    PubMed Central

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

    2015-01-01

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

  12. The means of contraception: the state of the art.

    PubMed

    Kome, P

    1977-05-26

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

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

    PubMed Central

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

    2013-01-01

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

  14. A Comparative Study of Iron Uptake Rates and Mechanisms amongst Marine and Fresh Water Cyanobacteria: Prevalence of Reductive Iron Uptake

    PubMed Central

    Lis, Hagar; Kranzler, Chana; Keren, Nir; Shaked, Yeala

    2015-01-01

    In this contribution, we address the question of iron bioavailability to cyanobacteria by measuring Fe uptake rates and probing for a reductive uptake pathway in diverse cyanobacterial species. We examined three Fe-substrates: dissolved inorganic iron (Fe') and the Fe-siderophores Ferrioxamine B (FOB) and FeAerobactin (FeAB). In order to compare across substrates and strains, we extracted uptake rate constants (kin = uptake rate/[Fe-substrate]). Fe' was the most bioavailable Fe form to cyanobacteria, with kin values higher than those of other substrates. When accounting for surface area (SA), all strains acquired Fe' at similar rates, as their kin/SA were similar. We also observed homogeneity in the uptake of FOB among strains, but with 10,000 times lower kin/SA values than Fe'. Uniformity in kin/SA suggests similarity in the mechanism of uptake and indeed, all strains were found to employ a reductive step in the uptake of Fe' and FOB. In contrast, different uptake pathways were found for FeAB along with variations in kin/SA. Our data supports the existence of a common reductive Fe uptake pathway amongst cyanobacteria, functioning alone or in addition to siderophore-mediated uptake. Cyanobacteria combining both uptake strategies benefit from increased flexibility in accessing different Fe-substrates. PMID:25768677

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  16. Immediate vs. delayed insertion of intrauterine contraception after second trimester abortion: study protocol for a randomized controlled trial

    PubMed Central

    2011-01-01

    Background We describe the rationale and protocol for a randomized controlled trial (RCT) to assess whether intrauterine contraception placed immediately after a second trimester abortion will result in fewer pregnancies than current recommended practice of intended placement at 4 weeks post-abortion. Decision analysis suggests the novel strategy could substantially reduce subsequent unintended pregnancies and abortions. This paper highlights considerations of design, implementation and evaluation of a trial expected to provide rigorous evidence for appropriate insertion timing and health economics of intrauterine contraception after second trimester abortion. Methods/Design Consenting women choosing to use intrauterine contraception after abortion for a pregnancy of 12 to 24 weeks will be randomized to insertion timing groups either immediately (experimental intervention) or four weeks (recommended care) post abortion. Primary outcome measure is pregnancy rate at one year. Secondary outcomes include: cumulative pregnancy rates over five year follow-up period, comprehensive health economic analyses comparing immediate and delayed insertion groups, and device retention rates, complication rates (infection, expulsion) and, contraceptive method satisfaction. Web-based Contraception Satisfaction Questionnaires, clinical records and British Columbia linked health databases will be used to assess primary and secondary outcomes. Enrolment at all clinics in the province performing second trimester abortions began in May 2010 and is expected to complete in late 2011. Data on one year outcomes will be available for analysis in 2014. Discussion The RCT design combined with access to clinical records at all provincial abortion clinics, and to information in provincial single-payer linked administrative health databases, birth registry and hospital records, offers a unique opportunity to evaluate such an approach by determining pregnancy rate at one through five years among enrolled women. We highlight considerations of design, implementation and evaluation of a trial expected to provide rigorous evidence for appropriate insertion timing and health economics of intrauterine contraception after second trimester abortion. Trial registration Current Controlled Trials ISRCTN19506752 PMID:21672213

  17. Ecological factors predicting adolescent contraceptive use: implications for intervention.

    PubMed

    Kastner, L S

    1984-04-01

    Questionnaires addressing areas expected to relate to contraceptive use were completed by 230 female adolescents. Contraceptive use among the 130 sexually active subjects were predicted by a model composed of 12 scales assessing social permissiveness, costs and benefits of contraception, parent communication, boyfriend support, sex education and knowledge, attitudes about pregnancy and contraception, and access to contraception services. Scales from the predictive model which raise ideas for potential intervention strategies assessed parent communication, boyfriend support, and perceived costs and benefits related to contraception. Since there has been public concern that intervention programs for enhancing adolescent contraceptive use might also stimulate sexual activity, correlations were computed between the predictive scales and the measure of sexual experience among all 230 subjects. These data indicated that positive parent communication about sexuality and a perception of high benefits and low costs associated with contraceptive use were not positively correlated with sexual experience. Implications for the prevention of adolescent pregnancy are discussed with an emphasis on designing innovative sex education, improving parent-child communication, resolving conflicts in contraceptive decisionmaking, and supporting the role of boyfriends in contraceptive use. PMID:6706793

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

    PubMed Central

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

    2013-01-01

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

  19. [Contraception in adolescence: knowing is not enough].

    PubMed

    Aman, M

    1985-10-01

    Sexuality is the source of the biological, psychic, and social changes of adolescence. Contraception, by modifying some aspects of sexuality, can change the usual course of adolescence. Sexuality is a new experience for adolescents and is submerged in the same confusion and uncertainty as other areas of their lives. The experience of health personnel in contraception over the years has been gained in prescription for adults, who unlike adolescents are members of stable couples who have found their places in society. Women seeking contraception have usually experienced pregnancy and verified their fecundity, thereby consolidating their identities, unlike the adolescent who is still unsure of her femininity. Contraception for adolescents, by blocking 2 stages in the life of a woman (proving fecundity and experiencing maternity) is an obstacle to the total achievement of adulthood. The connection between sex and pregnancy is recognized by a 13-year-old in a theoretical way, but is not always integrated as a practical reality. Many adults have difficulty accepting the contraception requests of adolescents because they do not feel it is morally right for adolescents to have direct sexual experiences rather than daydreams. The reality of adolescent sexual lives is quite different from what most adults adults imagine it to be. Mental integration of contraception for an adolescent requires acceptance of the link between sex and pregnancy and a mental representation of oneself and one's behavior in which sexuality is considered a possibility. Many adolescents believe that they are too young to become pregnant, or are unable to make the link between sex today and pregnancy in the future, or do not perceive a possible pregnancy in negative terms. After they perceive the need for contraception and develop a desire to meet the need, adolescents must gain knowledge of the different methods available. Choice of a method will be influenced by the degree of efficacy of the method, its cost, facility of use, the frequency of intercourse, secondary effects, social or religious prohibitions, desire to keep contraceptive use secret, and the possibility of involving the partner. Failure to use the chosen means may be caused by such external factors as absence of a nearby family planning center or lack of money, or by internal factors. THe presence of an adult at the contraception consultation may be perceived by the adolescent as a means of control. The consultation may signify to the adolescent a demand for recognition of the reality of his affective and sexual life, a rite of passage, a means of transgressing parental prohibitions, and an indication of acceptance of the dissociation of sexuality from fertility. The presence of the girl's mother can complicate the consultation. Very often the health care professional confuses the role of parent with the medical role, feeling a moral responsibility beyond helping the adolescent avoid pregnancy or abortion. The best course is to be available to listen to the adolescent without prejudice in order to permit the establishment of room for reflection and maturation. PMID:3853915

  20. MHC-correlated odour preferences in humans and the use of oral contraceptives

    PubMed Central

    Roberts, S. Craig; Gosling, L. Morris; Carter, Vaughan; Petrie, Marion

    2008-01-01

    Previous studies in animals and humans show that genes in the major histocompatibility complex (MHC) influence individual odours and that females often prefer odour of MHC-dissimilar males, perhaps to increase offspring heterozygosity or reduce inbreeding. Women using oral hormonal contraceptives have been reported to have the opposite preference, raising the possibility that oral contraceptives alter female preference towards MHC similarity, with possible fertility costs. Here we test directly whether contraceptive pill use alters odour preferences using a longitudinal design in which women were tested before and after initiating pill use; a control group of non-users were tested with a comparable interval between test sessions. In contrast to some previous studies, there was no significant difference in ratings between odours of MHC-dissimilar and MHC-similar men among women during the follicular cycle phase. However, single women preferred odours of MHC-similar men, while women in relationships preferred odours of MHC-dissimilar men, a result consistent with studies in other species, suggesting that paired females may seek to improve offspring quality through extra-pair partnerships. Across tests, we found a significant preference shift towards MHC similarity associated with pill use, which was not evident in the control group. If odour plays a role in human mate choice, our results suggest that contraceptive pill use could disrupt disassortative mate preferences. PMID:18700206

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

    PubMed

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

    2015-01-01

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

  2. Venous thrombosis in users of non-oral hormonal contraception: follow-up study, Denmark 2001-10

    PubMed Central

    2012-01-01

    Objective To assess the risk of venous thrombosis in current users of non-oral hormonal contraception. Design Historical national registry based cohort study. Setting Four national registries in Denmark. Participants All Danish non-pregnant women aged 15-49 (n=1?626?158), free of previous thrombotic disease or cancer, were followed from 2001 to 2010. Main outcome measures Incidence rate of venous thrombosis in users of transdermal, vaginal, intrauterine, or subcutaneous hormonal contraception, relative risk of venous thrombosis compared with non-users, and rate ratios of venous thrombosis in current users of non-oral products compared with the standard reference oral contraceptive with levonorgestrel and 30-40 µg oestrogen. Diagnoses were confirmed by at least four weeks of anticoagulation therapy after the diagnosis. Results Within 9?429?128 woman years of observation, 5287 first ever venous thrombosis events were recorded, of which 3434 were confirmed. In non-users of hormonal contraception the incidence rate of confirmed events was 2.1 per 10?000 woman years. Compared with non-users of hormonal contraception, and after adjustment for age, calendar year, and education, the relative risk of confirmed venous thrombosis in users of transdermal combined contraceptive patches was 7.9 (95% confidence interval 3.5 to 17.7) and of the vaginal ring was 6.5 (4.7 to 8.9). The corresponding incidences per 10?000 exposure years were 9.7 and 7.8 events. The relative risk was increased in women who used subcutaneous implants (1.4, 0.6 to 3.4) but not in those who used the levonorgestrel intrauterine system (0.6, 0.4 to 0.8). Compared with users of combined oral contraceptives containing levonorgestrel, the adjusted relative risk of venous thrombosis in users of transdermal patches was 2.3 (1.0 to 5.2) and of the vaginal ring was 1.9 (1.3 to 2.7). Conclusion Women who use transdermal patches or vaginal rings for contraception have a 7.9 and 6.5 times increased risk of confirmed venous thrombosis compared with non-users of hormonal contraception of the same age, corresponding to 9.7 and 7.8 events per 10?000 exposure years. The risk was slightly increased in women using subcutaneous implants but not in those using the levonorgestrel intrauterine system. PMID:22577198

  3. Sexual onset and contraceptive use among adolescents from poor neighbourhoods in Managua, Nicaragua

    PubMed Central

    Decat, Peter; De Meyer, Sara; Jaruseviciene, Lina; Orozco, Miguel; Ibarra, Marcia; Segura, Zoyla; Medina, Joel; Vega, Bernardo; Michielsen, Kristien; Temmerman, Marleen; Degomme, Olivier

    2015-01-01

    Abstract Background and objectives The prevalence of teenage pregnancies in Nicaragua is the highest in Latin-America. This study aimed to gain insight into factors which determine the sexual behaviours concerned. Methods From July until August 2011, a door-to-door survey was conducted among adolescents living in randomly selected poor neighbourhoods of Managua. Logistic regression was used to analyse factors related to sexual onset and contraceptive use. Results Data from 2803 adolescents were analysed. Of the 475 and 299 sexually active boys and girls, 43% and 54%, respectively, reported contraceptive use. Sexual onset was positively related to increasing age, male sex, alcohol consumption and not living with the parents. Catholic boys and boys never feeling peer pressure to have sexual intercourse were more likely to report consistent condom use. Having a partner and feeling comfortable talking about sexuality with the partner were associated with hormonal contraception. Conclusions Our data identified associates of adolescents’ sexual behaviour related to personal characteristics (sex and alcohol use), to the interaction with significant others (parents, partners, peers) and to the environment (housing condition, religion). We interpreted those associates within the context of the rapidly changing society and the recently implemented health system reform in Nicaragua. Chinese Abstract ?? ????? ??????????????????????????????????????? ?? 2011?7??8???????????????????????????????????????Logistic???????????????????? ?? ?????2 803?????????475??299????????????????43%?54%????????????????????????????????????????????????????????????????????????????????????????????????????????? ?? ?????????????????????????????????????????????????????????????????????????????٦

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

    PubMed Central

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

    2013-01-01

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

  5. New intrauterine technologies for contraception and treatment in nulliparous/adolescent and parous women

    PubMed Central

    Wildemeersch, D.

    2009-01-01

    The IUD (intra uterine device) is a highly effective method of contraception that is underused. New developments in intrauterine technology, smaller frameless copper and levonorgestrel-releasing devices, could help increase the prevalence of use in adolescents and nulliparous women. Because adolescents and young nulliparous women contribute disproportionately to the epidemic of unintended pregnancies, long-acting methods of contraception, particularly IUDs, should be considered as first-line choices for interval, emergency and immediate post-abortal contraception in this population of women. As the uterine cavity is generally much smaller in this group than in older women, adapted IUDs may be very useful. Compatibility of the IUD with the small uterine cavity leads to high acceptability and continuation of use, a prerequisite to reduce unintended pregnancies. A strategic advantage of IUDs is that, unlike the Pill, they are genuinely ‘fit-and-forget’. In use, they are much more effective than Pills in this age group. However, copper intrauterine devices do not offer protection against sexually transmitted infections (STIs) and, therefore, they are not always the methods of first choice for teenagers and nulliparous women. New evidence, however, from the World Health Organization and the American College of Obstetricians and Gynecologists, shows that IUDs can be used and that they are safe for most women, including adolescents. PMID:25489467

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

    PubMed Central

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

    2012-01-01

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

  7. The Influence of Oral Contraceptive Knowledge on Oral Contraceptive Continuation Among Young Women

    PubMed Central

    Castaño, Paula M.; Westhoff, Carolyn L.

    2014-01-01

    Abstract Background: Using a multidimensional approach, we assessed young women's knowledge of oral contraceptives (OC) and its influence on OC continuation rates. Methods: We used data from 659 women aged 13–25 years participating in a randomized controlled trial of an educational text message OC continuation intervention. Women received 6 months of daily text messages or routine care. At baseline and 6 months, we administered a comprehensive 41-item questionnaire measuring knowledge of OC's mechanism, effectiveness, use, side effects, risks, and benefits. We ascertained OC continuation status and reasons for discontinuation at 6 months. We analyzed relationships between OC knowledge and continuation with multivariable logistic regression. Results: Young women scored, on average, 22.8 out of 41 points on the OC knowledge assessment at baseline and 24.7 points at 6 months. The 6-month OC continuation rate was 59%. OC continuers had >2-points-higher OC knowledge scores at 6 months than discontinuers (p<0.001). Those who reported discontinuing their OCs for side effects and forgetfulness scored >2 points lower than women who discontinued for other reasons (p-values<0.001). In multivariable regression models, each correct response on the baseline and 6-month knowledge assessments was associated with a 4% and 6% increased odds of OC continuation, respectively. Six-month OC knowledge scores were negatively associated with OC discontinuation due to side effects (odds ratio [OR] 0.94) and forgetfulness (OR 0.88). Conclusions: OC knowledge, which was low among young women in our study, was associated with OC continuation and common reasons for discontinuation. Continued efforts to characterize relationships between OC knowledge and behavior and to test the effectiveness of different components of interventions aimed at increasing knowledge, addressing side effects, and improving use of OCs are warranted. PMID:24571282

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

    ClinicalTrials.gov

    2012-02-17

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

  9. Lacunar infarction with oral contraceptives: An unusual case report

    PubMed Central

    Biswal, Sasmita

    2013-01-01

    Combined oral contraceptives are one of the risk factor for stroke in women. We report a case of an arterial ischemic stroke due to lacunar infarction in a 35-year-old previously healthy female patient induced after 3 years on Sukhi an oral contraceptive after two times artificial abortions. A brain MRI finding was suggestive of lacunar infarction. Her symptoms improved after stopping the oral contraceptive and putting her on I.V heparin therapy. PMID:24672193

  10. Emergency contraception: randomized comparison of advance provision and information only

    Microsoft Academic Search

    Charlotte Ellertson; Shubba Ambardekar; Allison Hedley; Kurus Coyaji; James Trussell; Kelly Blanchard

    2001-01-01

    OBJECTIVE:To determine whether multiple courses of emergency contraceptive therapy supplied in advance of need would tempt women using barrier methods to take risks with their more effective ongoing contraceptive methods.METHODS:We randomly assigned 411 condom users attending an urban family planning clinic in Pune, India, to receive either information about emergency contraception along with three courses of therapy to keep in

  11. Cost savings from emergency contraceptive pills in canada

    Microsoft Academic Search

    James Trussell; Ellen Wiebe; Tara Shochet; Édith Guilbert

    2001-01-01

    Objective: To estimate cost savings from emergency contraceptive pills in Canada.Methods: We modeled cost savings when a single emergency contraceptive treatment was provided after unprotected intercourse and when women were provided emergency contraceptive pills in advance.Results: Each dollar spent on a single treatment saved $1.19–$2.35 (in Canadian currency), depending on the regimen and on assumptions about savings from costs avoided

  12. Use of Modern Contraception by the Poor Is Falling Behind

    Microsoft Academic Search

    Emmanuela Gakidou; Effy Vayena

    2007-01-01

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

  13. Peri-abortion contraception: a qualitative study of users' experiences

    Microsoft Academic Search

    Usha Kumar; Paula Baraitser; Sheila Morton; Helen Massil

    2004-01-01

    BackgroundContraceptive counselling is an essential element of induced abortion services but concerns remain about its effectiveness.ObjectiveThe issues that influence peri-abortion contraception were explored as part of a study on the experiences of women undergoing induced abortion.MethodIn-depth interviews with 21 women of varying ages, gestations and ethnicity, 3-9 weeks after termination of their pregnancy, with qualitative analysis of data.ResultsContraceptive risk-taking was

  14. An extended expectancy-value approach to contraceptive alternatives

    Microsoft Academic Search

    Joel B. Cohen; Lawrence J. Severy; Olli T. Ahtola

    1978-01-01

    This paper describes the application of an expectancy-value\\/normative-influence model to the understanding of contraceptive-choice behavior. Components of the model are identified and discussed with respect to issues raised by its application to contraceptive choice. Further, a pilot application of the approach is described. Encouraging pilot data suggest that important attitudinal and normative differences among both population and contraceptive-use groups can

  15. The emerging use of the 20-?g oral contraceptive

    Microsoft Academic Search

    Alfred Poindexter

    2001-01-01

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

  16. Intracranial venous thrombosis complicating oral contraception

    PubMed Central

    Dindar, F.; Platts, M. E.

    1974-01-01

    Four days after the onset of a severe headache a 22-year-old woman who had been taking oral contraceptives for less than three weeks had a convulsion, followed by right hemiparesis. Other focal neurologic signs and evidence of raised intracranial pressure appeared, and she became comatose on the seventh day. A left craniotomy revealed extensive cerebral venous thrombosis. She died the next day. On postmortem examination extensive thrombosis of the superior sagittal sinus and draining cerebral veins, and multiple areas of cerebral hemorrhage and hemorrhagic infarction were seen. Some of the superficial cerebral veins showed focal necrosis of their walls, and the lateral lacunae of the superior sagittal sinus contained proliferating endothelial cells. The adrenal veins were also thrombosed. The significance of these findings is discussed. The literature on cerebrovascular complications of oral contraception, particularly cerebral venous thrombosis, is reviewed. ImagesFIG. 1FIG. 2FIG. 3FIG. 4FIG. 5FIG. 6 PMID:4413961

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

    PubMed Central

    2014-01-01

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

  18. Vertebral artery occlusion and oral contraceptives.

    PubMed Central

    Ask-Upmark, E; Bickerstaff, E R

    1976-01-01

    If vertebral artery occlusion occurs in degenerative arterial disease it is almost invariably left-sided, but in vertebral artery deficiency syndromes associated with oral contraceptives a striking preponderance of right-sided involvement has been shown. This observation adds support to the view that causes other than changes in the wall of the vessel at the site of occlusion must be sought as an explanation of the occlusion. PMID:1252812

  19. Life-Threatening Complications of Hormonal Contraceptives: A Case History

    PubMed Central

    Khan, Saheed; Smulders, Yvo M.; de Vries, Johanna I. P.; Spoelstra-de Man, Angélique M. E.

    2013-01-01

    We present a case with the rare combination of thrombotic and hemorrhagic complications of oral contraceptives. A healthy 40-year-old woman suffered from cardiac arrest due to massive pulmonary embolism, caused by oral contraceptives and immobilization during a flight. After successful resuscitation, obstructive shock necessitated thrombolysis and thereafter heparin. Anticoagulation was complicated by internal bleeding from contraceptive related hepatic adenoma. She underwent arterial embolisation, and anticoagulation was continued. On day 18, she was discharged in a good condition. Hepatic adenomas are a potential source of internal bleeding in women using oral contraceptives requiring anticoagulation. Signs of internal bleeding in such patients should prompt immediate abdominal ultrasound examination. PMID:23762682

  20. [Status of problems with administration of hormonal contraceptives].

    PubMed

    Göretzlehner, G; Simon, E

    1999-01-01

    Following the application of oral hormonal contraceptives situations may occur which need fast clarification. In this report we discuss the practical aspects of forgetting to take hormonal contraceptives, the risk for birth defects, the time when to restart taking oral contraceptives after delivery and abortion, the indications for stopping the application, the taking of oral contraceptives under anticoagulant therapy, the behaviour during migraine, the raising need of ethinylestradiol in the case of epilepsy, the procedure in case of oligophrenia, the prevention of the rheumatoid arthritis as well as special questions in cases of diabetes mellitus and gestational diabetes. PMID:10091307

  1. [Cardiovascular risks of combined oral contraceptives - beyond the French controversy].

    PubMed

    Gronier, H; Gronier-Gouvernel, H; Robin, G

    2014-03-01

    Combined hormonal contraceptive is the most used contraceptive method in France among childbearing-aged women. Following the temporary delisting of oral contraception containing a 3rd generation progestin and following the market withdrawal of oral pills containing cyproterone acetate in combination with ethynil-estradiol (35?g), the impact of these events on our prescribing practice remains to determine. We will especially discuss the cardiovascular risk associated with combined hormonal contraceptives in the light of the most recent publications either with epidemiological or biological data. PMID:24582295

  2. Immunopharmacology of ulipristal as an emergency contraceptive

    PubMed Central

    Miech, Ralph P

    2011-01-01

    A new progesterone antagonist, ulipristal has been made available as an emergency contraceptive. Ulipristal’s major mechanism of action as an emergency contraceptive has been ascribed to its ability to delay ovulation beyond the life span of the sperm. This paper analyzes the potential action of ulipristal (1) when unprotected intercourse and administration of ulipristal occur outside the fertility window and (2) when unprotected intercourse and administration of ulipristal occur at or within 24 hours of ovulation. When unprotected intercourse and the use of a single low dose of ulipristal occur outside of the fertility window, ulipristal behaves like a placebo. When unprotected intercourse and the use of a single low dose of ulipristal occur within the fertility window but before ovulation, ulipristal behaves like an emergency contraceptive by delaying ovulation and thereby preventing fertilization. When unprotected intercourse and the administration of ulipristal occur at or within 24 hours of ovulation, then ulipristal has an abortifacient action. It is proposed that the abortifacient mechanism of a low dose of ulipristal taken after fertilization but before implantation is due to the ability of ulipristal to block the maternal innate immune system to become immunotolerant to the paternal allogenic embryo. Progesterone’s critical immunotolerant actions involving early pregnancy factor, progesterone-induced blocking factor, and uterine natural killer cells are compromised by ulipristal. PMID:22140327

  3. Immunopharmacology of ulipristal as an emergency contraceptive.

    PubMed

    Miech, Ralph P

    2011-01-01

    A new progesterone antagonist, ulipristal has been made available as an emergency contraceptive. Ulipristal's major mechanism of action as an emergency contraceptive has been ascribed to its ability to delay ovulation beyond the life span of the sperm. This paper analyzes the potential action of ulipristal (1) when unprotected intercourse and administration of ulipristal occur outside the fertility window and (2) when unprotected intercourse and administration of ulipristal occur at or within 24 hours of ovulation. When unprotected intercourse and the use of a single low dose of ulipristal occur outside of the fertility window, ulipristal behaves like a placebo. When unprotected intercourse and the use of a single low dose of ulipristal occur within the fertility window but before ovulation, ulipristal behaves like an emergency contraceptive by delaying ovulation and thereby preventing fertilization. When unprotected intercourse and the administration of ulipristal occur at or within 24 hours of ovulation, then ulipristal has an abortifacient action. It is proposed that the abortifacient mechanism of a low dose of ulipristal taken after fertilization but before implantation is due to the ability of ulipristal to block the maternal innate immune system to become immunotolerant to the paternal allogenic embryo. Progesterone's critical immunotolerant actions involving early pregnancy factor, progesterone-induced blocking factor, and uterine natural killer cells are compromised by ulipristal. PMID:22140327

  4. Contraceptive vaccines for wildlife: a review.

    PubMed

    Kirkpatrick, Jay F; Lyda, Robin O; Frank, Kimberly M

    2011-07-01

    Wildlife, free-ranging and captive, poses and causes serious population problems not unlike those encountered with human overpopulation. Traditional lethal control programs, however, are not always legal, wise, safe, or publicly acceptable; thus, alternative approaches are necessary. Immunocontraception of free-ranging wildlife has reached the management level, with success across a large variety of species. Thus far, the immunocontraceptive research and management applications emphasis have been centered on porcine zona pellucida and gonadotropin-releasing hormone vaccines. Contraceptive success has been achieved in more than 85 different wildlife species, at the level of both the individual animal and the population. At the population management level with free-ranging species, the primary focus has been on wild horses, urban deer, bison, and African elephants. The challenges in the development and application of vaccine-based wildlife contraceptives are diverse and include differences in efficacy across species, safety of vaccines during pregnancy, the development of novel delivery systems for wild and wary free-ranging animals, and the constraints of certain non-contraceptive effects, such as effects on behavior. Beyond the constraints imposed by the public and a host of regulatory concerns, there exists a real limitation for funding of well-designed programs that apply this type of fertility control. PMID:21501279

  5. Mechanism of action of levonorgestrel emergency contraception.

    PubMed

    Kahlenborn, Chris; Peck, Rebecca; Severs, Walter B

    2015-02-01

    There has been much debate regarding levonorgestrel emergency contraception's (LNG-EC's) method of action since 1999 when the Food and Drug Administration first approved its use. Proponents of LNG-EC have argued that they have moral certitude that LNG-EC works via a non-abortifacient mechanism of action, and claim that all the major scientific and medical data consistently support this hypothesis. However, newer medical data serve to undermine the consistency of the non-abortifacient hypothesis and instead support the hypothesis that preovulatory administration of LNG-EC has significant potential to work via abortion. The implications of the newer data have important ramifications for medical personnel, patients, and both Catholic and non-Catholic emergency room protocols. In the future, technology such as the use of early pregnancy factor may have the potential to quantify how frequently preovulatory LNG-EC works via abortion. Lay Summary: How Plan B (levonorgestrel emergency contraception) works has been vigorously debated ever since the Food and Drug Administration approved it in 1999. Many doctors and researchers claim that it has either no-or at most-an extremely small chance of working via abortion. However, the latest scientific and medical evidence now demonstrates that levonorgestrel emergency contraception theoretically works via abortion quite often. The implications of the newer data have important ramifications for medical personnel, patients, and both Catholic and non-Catholic emergency room rape protocols. PMID:25698840

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

    SciTech Connect

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

    1995-03-01

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

  7. Investigation of HIV Incidence Rates in a High-Risk, High-Prevalence Kenyan Population: Potential Lessons for Intervention Trials and Programmatic Strategies.

    PubMed

    Mdodo, Rennatus; Gust, Deborah; Otieno, Fredrick O; McLellan-Lemal, Eleanor; Chen, Robert T; Lebaron, Charles; Hardnett, Felicia; Turner, Kyle; Ndivo, Richard; Zeh, Clement; Samandari, Taraz; Mills, Lisa A

    2013-12-01

    Cost-effective HIV prevention programs should target persons at high risk of HIV acquisition. We conducted an observational HIV incidence cohort study in Kisumu, Kenya, where HIV prevalence is triple that of the national rate. We used referral and venue-sampling approaches to enroll HIV-negative persons for a 12-month observational cohort, August 2010 to September 2011, collected data using computer-assisted interviews, and performed HIV testing quarterly. Among 1292 eligible persons, 648 (50%) were excluded for HIV positivity and other reasons. Of the 644 enrollees, 52% were women who were significantly older than men (P < .01). In all, 7 persons seroconverted (incidence rate [IR] per 100 person-years = 1.11; 95% confidence interval [CI] 0.45-2.30), 6 were women; 5 (IR = 3.14; 95% CI 1.02-7.34) of whom were ?25 years. Most new infections occurred in young women, an observation consistent with other findings in sub-Saharan Africa that women aged ?25 years are an important population for HIV intervention trials in Africa. PMID:24309755

  8. Effects of the contraceptive skin patch and subdermal contraceptive implant on markers of endothelial cell activation and inflammation.

    PubMed

    Hernandez-Juarez, Jesus; Sanchez-Serrano, Juan Carlos; Moreno-Hernandez, Manuel; Alvarado-Moreno, Jose Antonio; Hernandez-Lopez, Jose Rubicel; Isordia-Salas, Irma; Majluf-Cruz, Abraham

    2015-07-01

    Changes in blood coagulation factors may partially explain the association between hormonal contraceptives and thrombosis. Therefore, the likely effects of the contraceptive skin patch and subdermal contraceptive implant on levels of inflammatory markers and endothelial activation were analyzed. This was an observational, prospective, longitudinal, nonrandomized study composed of 80 women between 18 and 35 years of age who made the decision to use the contraceptive skin patch or subdermal contraceptive implant. vascular cell adhesion molecule-1 (VCAM-1), endothelial cell leukocyte adhesion molecule-1 (ELAM-1), von Willebrand factor (VWF), and plasminogen activator inhibitor type 1(PAI-1) as well as high-sensitivity C-reactive protein (hsCRP) were assayed before and after 4 months of use of the contraceptive method. VCAM-1, VWF, and PAI-1 remained unchanged in the contraceptive skin patch group; however, a significant increase in hsCRP (0.29-0.50?mg/dL; P?=.012) and a significant decrease in ELAM-1 (44-25?ng/mL; P?=.022) were observed. A significant diminution in VCAM-1 (463-362?ng/mL; P?=.022) was also found in the subdermal contraceptive implant group. Our results strongly suggest that these contraceptive methods do not induce endothelial activation after 4 months of use. Increase in hsCRP levels was unrelated to changes in markers of endothelial activation. PMID:25655356

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

    PubMed Central

    Bailey, Martha J.

    2014-01-01

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

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

    Microsoft Academic Search

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

    2004-01-01

    About half of the 1.2 million abortions each year in the United States are repeat abortions. While most abortion providers counsel women about contraception, one reason for the high repeat rate could be failure to take into account the social context of the women—in particular, the male partner. To assess whether there might be a window of opportunity for a

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

    ERIC Educational Resources Information Center

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

    2014-01-01

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

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

    PubMed

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

    2014-11-01

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

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

    PubMed Central

    2013-01-01

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

  14. Association between increased availability of emergency contraceptive pills and the sexual and contraceptive behaviors of women.

    PubMed

    Atkins, Danielle N

    2014-08-01

    In the United States (US), access to emergency contraceptive pills (ECPs) expanded to nationwide in 2006 when regulators allowed Plan B, a brand of emergency contraception, to be sold without prescription. Using data from the National Health and Nutrition Examination Survey from 2001 to 2010, I examined any association between increased access to these ECPs in the US and negative consequences. I found an association between increased access to ECPs and a 2.2 per cent higher probability of any sexual activity, a 5.2 per cent increase in the likelihood of reporting sex with multiple partners, an increase in the average number of partners by 0.35, and a -7.6 per cent decrease in the likelihood of injectable contraceptive use. These results suggest that policies in the US and other countries that expand access to ECPs should be paired with information on ECPs' lack of protection against sexually transmitted infections and relatively lower efficacy compared to other forms of contraception. PMID:24573239

  15. Multiple hepatocellular tumours in a patient treated with oral contraceptives

    Microsoft Academic Search

    William L. Brander; Gregory Vosnides; Chisholm S. Ogg; Iain E. West

    1976-01-01

    A case of multiple hepatic tumours in a patient treated for four years with high doses of oral contraceptives is described. Solitary hepatocellular lesions associated with conventional doses of oral contraceptives have been reported previously in twenty nine cases. Haemorrhage has been a common mode of presentation and is attributed to the marked vascularity of the lesions, an appearance referred

  16. Reducing Unintended Pregnancy by Increasing Access to Emergency Contraceptive Pills

    Microsoft Academic Search

    Maxine Hayes; Jane Hutchings; Pamela Hayes

    2000-01-01

    Objectives: National and state data on the health, social, and economic consequences of unintended pregnancy prompted Washington policy makers to identify strategies to reduce such pregnancies. Though not well known, emergency contraceptive pills (ECPs) are a safe and effective contraceptive method that can prevent pregnancy if taken within 72 hr after unprotected intercourse. A coalition conceived the idea of enabling

  17. Pharmacy Access to Emergency Contraception in Rural and Frontier Communities

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  18. Social Work Student Attitudes Toward Contraception and the HPV Vaccine

    Microsoft Academic Search

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

    2012-01-01

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

  19. The Use of Contraception by Women with Intellectual Disabilities

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  20. Status and future direction of male contraceptive development

    Microsoft Academic Search

    C Richard Lyttle; Gregory S Kopf

    2003-01-01

    Control of fertility constitutes a global health issue, as overpopulation and unintended pregnancy have both major personal and societal impact. Although the contraceptive revolution in the 1960s following the development of hormonal-based oral contraceptives for women has had a major impact on societal dynamics in several cultures, little product innovation has occurred since then. One solution to this global health

  1. Promoting the Safety and Use of Hormonal Contraceptives

    Microsoft Academic Search

    Jacqueline Gardner; Leslie Miller

    2005-01-01

    Nearly one half of all pregnancies in the United States are unintended despite the availabil- ity of safe and effective contraceptives. The morbidity and mortality from unintended preg- nancy are not insignificant. Currently available hormonal contraceptives are very effective, safe, and available for most American women. National and international institutions have removed the pelvic examination as a requirement for initiating

  2. Human Capital, Religion and Contraceptive Use in Ghana

    Microsoft Academic Search

    Niels-Hugo Blunch

    While previous studies of contraceptive use have considered the influence of education and religion, there are still a lot to be learned about how education and religion affects contraceptive use. Examining a nationally representative household survey of married or attached Ghanaian women, this paper adds to this literature by considering the potential influence from participation in adult literacy programs and

  3. Chlamydia trachomatis and oral contraceptive use: a quantitative review

    Microsoft Academic Search

    J Cottingham; D Hunter

    1992-01-01

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

  4. HEALTH MATTERS Dispelling Common Myths About Intrauterine Contraception

    E-print Network

    Yener, Aylin

    pill" when talking about birth control (contraception). Although the pill is very popular, there are many different birth control methods. Learning about different options can help you choose a method that's best for you and your lifestyle. Intrauterine contraception (IUC) is a convenient birth control

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

    ERIC Educational Resources Information Center

    Toews, Michelle L.; Yazedjian, Ani

    2012-01-01

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

  6. Compliance, counseling and satisfaction with oral contraceptives: a prospective evaluation.

    PubMed

    Rosenberg, M J; Waugh, M S; Burnhill, M S

    1998-01-01

    The Organon Contraceptive Use Study, a prospective cohort study (1994-96) of 943 US women (mean age, 25 years) recruited through private medical practices, Planned Parenthood clinics, and a health maintenance organization, examined oral contraceptive (OC) use patterns. 95% of study participants began or switched to a new OC brand at study enrollment. At follow up 2 months after enrollment, 47% of pill users reported missing 1 or more pill per cycle and 22% missed 2 or more pills in each cycle. Those who missed 1 or more pill were significantly more likely than those who did not to lack an established pill-taking routine, not to have read or understood the informational material accompanying the pill, and to have experienced spotting or heavy bleeding. 34% rated the OC as a very good method and another 30% considered it a good method. Method satisfaction was significantly higher among OC users who were aware of the pill's noncontraceptive health benefits, had a good relationship with their OC provider, had used the pill in the past, and experienced few side effects. 22% of OC recipients called their provider at least once about pill-related side effects and 9% visited at least once for this reason; these women spent US$25 and $62, respectively, to treat side effects. Recommended, to increase patient compliance and satisfaction with OCs, are measures such as counseling on potential side effects, evaluations of consistency of use at all follow-up contacts, and attention to the quality of the provider-client relationship. PMID:9561874

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

    PubMed Central

    2014-01-01

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

  8. Counselling on contraceptive use strengthened in Dominican Republic.

    PubMed

    1994-01-01

    In the Dominican Republic a study was conducted to identify the main factors associated with the occurrence of induced abortion. The study involved interviews with 350 women admitted in two hospitals with abortion complications, review of their clinical records, and in-depth interviews with 30 of these patients. The results indicated that the majority of these women had a low socioeconomic status and a low level of education. Many were born in rural areas but had migrated to Santo Domingo, the capital, in search of employment. Their average age was about 26 years. Adolescents represented 16% of the total study sample. Most of these women were in some sort of union, but only 13% were formally married. Contrary to popular belief that it is only unmarried adolescents who resort to induced abortions, the study showed that the majority were in permanent or semi-permanent unions. In fact, most of them had been in the union for three or more years. The use of contraception was low and unsystematic, with high discontinuation rates. Although 75% of the total study population declared to have used at least one contraceptive method during their lifetime, only 42% had tried a second method. This project has had a significant policy impact. In 1993, a revised Health Code was presented to the Dominican Congress for discussion and approval. The Senator who introduced this legislation, using results from the study, proposed to modify the law with respect to therapeutic abortions to include a clause that would make abortion legal under certain conditions and make corresponding services available as part of maternal and child health care programs. Also, with a view to lowering the incidence of abortion, PROFAMILIA, an agency affiliated to the international Planned Parenthood Federation, has adopted improved measures, reinforcing counselling and communication efforts to improve understanding of the correct way of using modern methods. PMID:12287988

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

    PubMed Central

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

    2011-01-01

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

  10. Interaction of anticonvulsants and oral contraceptives in epileptic adolescents.

    PubMed

    Diamond, M P; Greene, J W; Thompson, J M; VanHooydonk, J E; Wentz, A C

    1985-06-01

    Oral contraceptives are in widespread use, and are commonly prescribed for contraception in patients taking other medications. An example of this is the concomitant use of oral contraceptives and anticonvulsants in epileptic patients. This combination creates a potential for drug interactions which may alter the efficacy of both medications. An apparent interaction between oral contraceptives and anticonvulsants was observed in this study of epileptic adolescent females. This interaction was evidenced by menstrual irregularities which occurred in 65% (7 of 11) of adolescents on both medications concomitantly. The frequency of irregularity was significantly higher in these adolescents when compared to adolescents on either medication alone. Irregularities appeared to be alleviated by increasing the strength of the oral contraceptive, and although a concern, the increased dosage did not affect seizure control. PMID:4042660

  11. Women's socioeconomic position and contraceptive behavior in Togo.

    PubMed

    Gage, A J

    1995-01-01

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

  12. Delaying pelvic exams to encourage contraceptive use.

    PubMed

    Donovan, P

    1992-01-01

    The Family Planning Council of Southeastern Pennsylvania created a project called Start Smart, permitting some new adolescent clients to delay blood tests and pelvic exams up to 6 months after their oral contraceptive prescription. The rationale for the trial is the perception that fear of the pelvic exam is one of the reasons why teen women delay coming to medical care for contraception for 1 year on average after becoming sexually active. 5 clinics participated in the pilot trial from November 1988 to March 1990, giving anticipatory counseling and follow-up telephone calls to all young women in the program, and permitting postponement of the medical work-up to certain teens in 3 of the clinics. Special waivers from the Department of Health and Human Services were needed to permit the exception under Title K. These women had a comprehensive family, social, and medical history, weight, height, blood pressure, urinalysis, and pregnancy test. 627 teens aged 11-17 participated in the pilot trail; 90% were already sexually active; 33% had been so for 1 year; 25% had never used contraception. 25% decided to delay pelvic exams and 40% elected to delay blood tests. Most accepted pelvic exams on their 2nd visit. Those who delayed attended the clinic slightly more often than did others. Although there were no significant results, there were also no adverse medical consequences, such as missed sexually transmitted disease infections. The staff participating in this trial thought the teens had an added sense of control over their medical care. PMID:1628718

  13. Long-Acting Reversible Contraception for Adolescents.

    PubMed

    Fontenot, Holly B; Fantasia, Heidi Collins

    2015-06-01

    In 2013 and 2014, the Centers for Disease Control and Prevention (CDC) publicized its recommendations for the use of long-acting reversible contraception (LARC) (including intrauterine devices and implants) as first-line, highly effective options for pregnancy prevention. The use of LARC by adolescents has had growing support by national health and women's health organizations. Ongoing research is beginning to uncover facilitators and barriers to LARC use in adolescents. The purpose of this column is to highlight two recent U.S.-based studies in which researchers examined perspectives related to and factors associated with LARC use in adolescent and young adult women. PMID:26058908

  14. [Update on current care guidelines: emergency contraception].

    PubMed

    2011-01-01

    Three methods of emergency contraception (EC) are currently available in Finland. Levonorgestrel (LNG) method (a single dose 1,5 mg of levonorgestrel within 72 hours after unprotected sexual intercourse (UPSI)) is available over-the-counter for people aged at least 15 years. Copper-IUD, inserted within 120 hours after UPSI is the most effective method, and availability of this method should be improved in primary health care. If time elapsed since UPSI is between 72 and 120 hours, and IUD cannot be inserted, ulipristal (30 mg as single dose) probably prevents pregnancy more effectively than LNG in this period of time. PMID:21442878

  15. Condoms: still the most popular contraceptive.

    PubMed

    Silverstone, T

    1997-01-01

    Condoms can be used as a barrier contraceptive and/or to protect against many sexually-transmitted diseases. They are easy to buy and use and free from medical risk. Carefully used, and used in conjunction with a spermicide, condoms have similar reliability to IUDs, progesterone-only pills and the diaphragm. The condom must be put on before the penis touches the vaginal area. The penis should not touch the vaginal area after the condom has been taken off. Oil-based products, eg baby oil, massage oil, lipstick, petroleum jelly, suntan oil, can damage the condom. If a lubricant is required, use one that is water-based. PMID:9348972

  16. An Oral Contraceptive Drug Interaction Study

    NSDL National Science Digital Library

    Bradstreet, Thomas E.

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

  17. Modernism and contraceptive use in Colombia.

    PubMed

    Baldwin, W H; Pitt Ford, T R

    1976-03-01

    This analysis addresses the question of whether fertility can be lowered without the prior occurrence of the social and economic changes that have come to be labeled modernization. The data show that there exists in Colombia a relatively high level of motivation to control fertility that, for many women, is not coupled with both knowledge of and access to a method of contraception. For the "traditional" woman, the problem may not be lack of motivation so much as lack of access to methods that she is aware of, such as the pill, and lack of knowledge of methods that require few resources of supplies, such as rhythm and withdrawal. PMID:1273911

  18. Contraceptive options for women in selected circumstances.

    PubMed

    Weisberg, Edith

    2010-10-01

    Young women under the age of 16 years require special consideration when requesting contraception. Such young women can give voluntary consent, which enables prescription and supply providing that the practitioner has determined that the minor is sufficiently mature to understand the details of the method and its use. All reversible methods may be appropriate but it is necessary to provide information in a form that is fully understood. For women with pre-existing medical conditions including obesity, the benefits and risks of the use of individual methods needs to be weighed against the risks of pregnancy for that woman. PMID:20434405

  19. Hormonal contraceptive use and mate retention behavior in women and their male partners

    E-print Network

    Little, Tony

    contraceptive, 44.8%, other hormonal contraceptive, 1.1%), but also in emerging and developing economiesHormonal contraceptive use and mate retention behavior in women and their male partners Lisa L Available online 18 November 2011 Keywords: Mate retention behavior MRI-SF Hormonal contraception Mate

  20. Patients' attitudes and experiences related to receiving contraception during abortion care

    Microsoft Academic Search

    Megan L. Kavanaugh; Elizabeth E. Carlin; Rachel K. Jones

    2011-01-01

    BackgroundHigh risk for additional unintended pregnancies among abortion patients makes the abortion care setting an ideal one for facilitating access to contraception. This study documents attitudes of abortion patients about contraceptive services during their receipt of abortion services and identifies patient characteristics associated with desire for contraception and interest in using a long-acting reversible contraceptive method (LARC).

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

    PubMed

    Secura, G

    2013-06-01

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

  2. Knowledge and attitudes of Latin American gynecologists regarding unplanned pregnancy and use of combined oral contraceptives

    PubMed Central

    Bahamondes, Luis; Lira-Plascencia, Josefina; Martin, Ricardo; Marin, Victor; Makuch, Maria Y

    2015-01-01

    Background Unintended pregnancy is a public health problem and unmet medical need worldwide. It is estimated that in the year 2012, almost 213 million pregnancies occurred, and the global pregnancy rate decreased only slightly from 2008 to 2012. It was also estimated that 85 million pregnancies (40% of all pregnancies) were unintended and that 38% ended in an unintended birth. Objectives To assess knowledge and attitudes of Latin American (LA) obstetricians and gynecologists (OBGYNs) regarding unintended pregnancies and aspects of combined oral contraceptive (COC) use. Methods A survey was conducted during a scientific meeting about contraception in 2014, in which OBGYNs from 12 LA countries who provide attention in contraception were invited to respond to a multiple-choice questionnaire to assess their knowledge and attitudes regarding unplanned pregnancy and some aspects regarding COC use. Results A total of 210 OBGYNs participated in the study. Their knowledge regarding COC failure was low. The participants reported they believed that their patients habitually forgot to take a pill and that their patients did not know what to do in these situations. They were aware of the benefits of COC use; however, they were less prone to prescribe COCs for the purpose of protecting against ovarian and endometrial cancer, and one-quarter of them had doubts about the association between COC use and cancer risk. Conclusion The interviewed LA OBGYNs showed some flaws in terms of knowledge of COC failure rates and the non-contraceptive benefits and risks of COCs. To adequately counsel their patients regarding COC intake, OBGYNs must be updated regarding all aspects of COC use. PMID:25999766

  3. Induction of Contraception by Intraepididymal Sclerotherapy

    PubMed Central

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

    2014-01-01

    Purpose The objective of the present study was to evaluate the efficacy of a sclerosing solution for inducing epididymal occlusion in male rats. Materials and Methods Male Sprague-Dawley rats were divided into two groups: an injection group (n=20) and control group (n=20). Before injecting the sclerosing agent, seminal vesiculectomy and sperm identification using electrostimulation were performed in all of the rats. In the injection group, 0.2 mL of 0.1% sodium tetradecyl sulfate solution was injected into the epididymis. In the sham group, only the identification of the epididymis was performed. At 4 and 12 weeks after the injection, semen was collected by electrostimulation and evaluated to assess the contraceptive effect. Epididymis was evaluated by hematoxylin and eosin (H&E) staining. Results After 4 and 12 weeks, semen collection was performed in the two groups. Sperms were not observed in the injection group, while there was no change in the sperms in the sham group. H&E staining showed the obstruction of epididymal tubules and an accumulation of inflammatory cells in the injection group. Conclusions This study showed that the sclerosing agent induced sterilization in male rats. This result suggests that the injection method can replace vasectomy as a contraceptive method. However, a further study of large animals and a clinical study are needed. Further, the long-term effectiveness of this method needs to be studied. PMID:25237657

  4. Prophylactic contraceptives for HIV/AIDS.

    PubMed

    Uckun, F M; D'Cruz, O J

    1999-01-01

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

  5. Beyaz®: an oral contraceptive fortified with folate.

    PubMed

    Fruzzetti, Franca

    2012-01-01

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

  6. RISUG: An intravasal injectable male contraceptive

    PubMed Central

    Lohiya, N.K.; Alam, I.; Hussain, M.; Khan, S.R.; Ansari, A.S.

    2014-01-01

    Over the last two decades RISUG has been drawing attention in the field of male contraception. It promises to sterile men for a period of up to 10-15 years. According to recent studies in animal models, it proves to be completely reversible. Practically, there are no better options available that can assure complete sterility and precise reversibility. Regardless of so much of information available, RISUG is still holding up for many reasons, firstly, the available information engender bewilderment such as what is this copolymer, how does it work and is reversal really possible? Secondly, advancement of this outstanding invention is drastically slow and thirdly, effects of long-term contraception with RISUG and reports on evaluation of anomalies (if any) in F1, F2 progenies, are lacking. In this review the lacunae as well as advances in the development of RISUG in the light of published work and available resources are pointed out. Formulation of the RISUG, its mode of action and clinical trials have been addressed with particular emphasis. PMID:25673546

  7. Post-abortion contraception: care and practices1

    PubMed Central

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

    2014-01-01

    Objective to analyze assistance regarding contraception methods received by women during hospitalization due to abortion, and contraceptive practices the month after this episode. Methods a longitudinal study of women hospitalized due to abortion in a public hospital in the city of São Paulo. Face-to-face interviews (n=170) followed by telephone interviews in the subsequent month (n=147) were conducted between May and December of 2011. Results a small number of women reported they received guidance on, and prescription for, contraceptive methods at hospital discharge. A trend of statistical significance was identified for prescription of contraceptive methods at discharge and its use in the following month, when adjusted for age. Most women reported sexual intercourse (69.4%) with the use of contraceptive method (82.4%), but no health professional guidance (63.1%). Conclusion despite the fact that post-abortion contraception assistance was lower than the recommended guidelines by public health policies, women demonstrated willingness to use contraceptive methods. PMID:26107838

  8. [Benign increase in intracranial pressure during oral contraception (author's transl)].

    PubMed

    Janzik, H H

    1973-10-01

    The case of a 27-year-old woman treated with oral contraceptives (most recently with Anovlar) who developed intracranial hypertension is reported. The woman presented with visual disturbances, fatigue, and headaches. Oculo-circulatory and cerebral neoplastic diseases were not present, but high intracranial pressure was noted; no etiological clarification could be found. Discontinuation of contraceptive medication was followed by near-normalization of vision and disappearance of other symptoms. During a 3-year follow-up period no neurological disorders apart from mild limitation of the visual field could be observed. A connection between the elevated intracranial pressure and oral contraception seems probable. PMID:4744374

  9. Prevalence Projections

    Cancer.gov

    Close Window State Cancer Profiles Quick Reference Guides ? Quick Reference Guides Index Prevalence Projections Send to Printer Text description of this image. Site Home Policies Accessibility Viewing Files FOIA Contact Us U.S. Department of Health

  10. Emergency contraception: a contraceptive intervention approaching target despite controversy and opposition

    Microsoft Academic Search

    Narendra Nath Sarkar

    2006-01-01

    The objective of this study is to make the public aware of progress, safety, effectiveness of use, acceptance, and over-the-counter availability of emergency contraception (EC). Data were extracted from the literature for the period 2000–2006 via MEDLINE using a keyword, and also from some pre-2000 journals. Randomised trials, reviews, surveys, clinical investigations, and articles relevant to the subject matter are

  11. Knowledge of contraceptives and sexually transmitted diseases and contraceptive practices amongst young people in Ho Chi Minh City, Vietnam.

    PubMed

    Nguyen, Hoa Ngan; Liamputtong, Pranee; Murphy, Gregory

    2006-05-01

    In this article, we examine knowledge of contraceptives and sexually transmitted diseases (STDs) and contraceptive practices amongst young Vietnamese people. We conducted a qualitative study on sexuality and abortion with young people in Ho Chi Minh City, Vietnam. Twelve female and 4 male young people were individually interviewed using an in-depth interview technique. We found that condoms and pills were contraceptives known by almost all young people, but their knowledge of condoms and pills was still inadequate. Fears of side effects of taking pills and rumors and beliefs regarding condoms were quite common among young people. The limitations in young people's knowledge of contraceptives and STDs were a reflection of limited sources of their knowledge. Sexual education provided by educational institutions and within families was very basic. It did not provide clear knowledge on the sensitive topics such as contraceptive methods, and other issues related to sexuality for unmarried people. From a gender perspective, there are two points to note here: While sex issues were discussed openly among unmarried men, most unmarried women felt uncomfortable or expressed difficulty when talking about these issues; and the passiveness of unmarried women in making the decision of using condoms as well as contraceptives was marked. Amongst young people, the use of contraceptives was based mainly on ineffective methods including withdrawal and periodic abstinence. Further, young people's understanding of these methods was neither clear nor adequate. For the young people who did not use any contraceptives, sexual relations occurred unexpectedly. We conclude that creating a climate in which sexual issues can be discussed openly is an important step for the improvement of sexual health for young people. This will inevitably improve knowledge and understanding of contraceptives and STDs and may lead to a safer sexual life among this group of young people. PMID:16877291

  12. Mechanism of action of emergency contraception.

    PubMed

    Gemzell-Danielsson, Kristina

    2010-11-01

    A major barrier to the widespread acceptability and use of emergency contraception (EC) are concerns regarding the mechanisms of action of EC methods. Today, levonorgestrel (LNG) in a single dose of 1.5 mg taken within 120 h of an unprotected intercourse is the most widely used EC method worldwide. It has been demonstrated that LNG-EC acts through an effect on follicular development to delay or inhibit ovulation but has no effect once luteinizing hormone has started to increase. Thereafter, LNG-EC cannot prevent ovulation and it does not prevent fertilization or affect the human fallopian tube. LNG-EC has no effect on endometrial development or function. In an in vitro model, it was demonstrated that LNG did not interfere with blastocyst function or implantation. PMID:20933113

  13. Mechanisms of action of oral emergency contraception.

    PubMed

    Gemzell-Danielsson, Kristina; Berger, Cecilia; Lalitkumar, P G

    2014-10-01

    This review gives an overview of the mechanisms of action of oral emergency contraception pills (ECPs), focusing on the levonorgestrel (LNG) and ulipristal acetate (UPA) containing ECPs. In vivo and in vitro studies have addressed the effect of EC on various possible targets. Based on these studies as well as on clinical trials it is clear that the efficacy of ECPs to prevent an unintended pregnancy depends on their mechanism of action as well as on their use in relation to the fertile window. While the main effect of both available ECPs is to prevent or delay ovulation the window of action for UPA is wider than that of LNG. This provides the biological explanation for the difference observed in clinical trials and the higher efficacy of UPA. Neither LNG nor UPA impairs endometrial receptivity or embryo implantation. Correct knowledge on the mechanism of action of ECPs is important to avoid overestimating their effectiveness and to advise women on correct use. PMID:25117156

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2004-05-01

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

  16. As the world grows: contraception in the 21st century

    PubMed Central

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

    2008-01-01

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

  17. 21 CFR 884.5350 - Contraceptive diaphragm and accessories.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...contraceptive diaphragm is a closely fitting membrane placed between the posterior aspect of the pubic bone and the posterior vaginal fornix. The device covers the cervix completely and is used with a spermicide to prevent pregnancy. This generic type...

  18. 21 CFR 884.5350 - Contraceptive diaphragm and accessories.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...contraceptive diaphragm is a closely fitting membrane placed between the posterior aspect of the pubic bone and the posterior vaginal fornix. The device covers the cervix completely and is used with a spermicide to prevent pregnancy. This generic type...

  19. 21 CFR 884.5350 - Contraceptive diaphragm and accessories.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...contraceptive diaphragm is a closely fitting membrane placed between the posterior aspect of the pubic bone and the posterior vaginal fornix. The device covers the cervix completely and is used with a spermicide to prevent pregnancy. This generic type...

  20. 21 CFR 884.5350 - Contraceptive diaphragm and accessories.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...contraceptive diaphragm is a closely fitting membrane placed between the posterior aspect of the pubic bone and the posterior vaginal fornix. The device covers the cervix completely and is used with a spermicide to prevent pregnancy. This generic type...

  1. 21 CFR 884.5350 - Contraceptive diaphragm and accessories.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...contraceptive diaphragm is a closely fitting membrane placed between the posterior aspect of the pubic bone and the posterior vaginal fornix. The device covers the cervix completely and is used with a spermicide to prevent pregnancy. This generic type...

  2. Methodologies for Evaluating the Impact of Contraceptive Social Marketing Programs.

    ERIC Educational Resources Information Center

    Bertrand, Jane T.; And Others

    1989-01-01

    An overview of the evaluation issues associated with contraceptive social marketing programs is provided. Methodologies covered include survey techniques, cost-effectiveness analyses, retail audits of sales data, time series analysis, nested logit analysis, and discriminant analysis. (TJH)

  3. Contraception in patients with systemic lupus erythematosus and antiphospholipid syndrome.

    PubMed

    Sammaritano, L R

    2014-10-01

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

  4. [Individualization of low-dose oral contraceptives. Pharmacological principles and practical indications for oral contraceptives].

    PubMed

    Cianci, A; De Leo, V

    2007-08-01

    The contraceptive pill has been a revolution of the last 40 years. In Italy, however, it is much less widely used than in other countries. Explanations for this phenomenon range from religious implications and customs to misinformation and word-of-mouth communication of negative experiences. The oral contraceptive pill is often used to correct menstrual disorders, leading to poor results and side-effects. Recent advances in oral contraception have led to a substantial reduction in doses and side-effects. Low-dose pills contain minimal doses of progesterones and estrogens and ensure good control of the menstrual cycle. Although reduction of ethinyl estradiol (EE) concentrations has reduced the incidence of negative systemic side effects such as water retention, edema and swollen breasts, the low estrogen dose may be associated with spotting and hypomenorrhea or amenorrhea in the long term, as well as dyspareunia due to reduced vaginal trophism, which may induce women to suspend use of the drug. It is also true that only one type of estrogen is used in the pill, albeit at different doses, whereas the progesterone may differ and in many cases is the cause of common side-effects. The choice of progesterone therefore involves not only its effect on the endometrium in synergy with estrogen, but also possible residual androgenic activity which may have negative metabolic repercussions. Indeed, addition of a progesterone, especially androgen-derived, attenuates the positive metabolic effects of estrogen. Two new monophasic oral contraceptives were recently released. They contain 30 microg (Yasmin) or 20 muicrog (Yasminelle) EE and a new progesterone, drospirenone, derived from spirolactone, which has antiandrogenic and antimineralcorticoid activity similar to endogenous progesterone. Like progesterone, the drospirenone molecule is an aldosterone antagonist and has a natriuretic effect that opposes the sodium retention effect of EE. It may, therefore, help to prevent the water retention, weight gain and arterial hypertension often associated with oral contraceptive use. Recent comparative studies recorded weight loss that stabilized after 6 months of treatment with drospirenone/EE. Overweight women may therefore benefit from the formulation with 20 microg EE, whereas the formulation with at least 30 microg EE should be more appropriate for underweight women. Women with slight to moderate acne, the formulation with 30 microg EE has been found to be as effective as 2 mg cyproterone acetate combined with 35 micrig EE (Diane). Menstrual cycle characteristics, however, remain the main factor determining the choice of formulation. Randomised control studies comparing the new formulation with others containing second or third generation progesterones have found similar efficacy in cycle control and incidence of spotting. From this point of view, it is not advisable to prescribe more than 30 microg EE (Yasmin or Yasminelle) for women with normal menstrual cycles, whereas in cases of hypomenorrhea and/or amenorrhea at least this dose of EE plus drospirenone may be used. Women with hypermenorrhea run the risk of spotting if an inappropriate drug is chosen. A solution is to use 30 microg EE/drospirenone from day 5 of the cycle. To control so-called minor side-effects, the dose of EE must be appropriate. In women with premenstrual tension a dose of at least 30 microg EE associated with drospirenone reduces or even prevents symptoms. On the other hand, in cases of chronic headache or headache as a side-effect of oral contraceptive use, a lower dose of estrogen is beneficial, and doses below 20 microg may be used. Although the progesterone component is not considered to affect headache, good results have been obtained with drospirenone, the antimineralcorticoid effects of which reduce blood pressure and improve symptoms. Formulations with 20 microg EE and drospirenone are particularly indicated in women with pre-existing mastodynia, fibrocystic breast manifestations or who develop mastodynia as a side-effect of oral contraceptive use. Since hi

  5. Contraceptive method mix menu: providing healthy choices for women.

    PubMed

    Greenwell, K F

    1996-01-01

    This article addresses expansion of the contraceptive method mix, in the specific context of underserved women in developing countries who, like all women, expect to maintain their health status while successfully regulating their fertility. It is a critical review of the health implications of the contraceptive methods most commonly included on a menu of options and includes fertility awareness methods as essential non-supply method options where barriers currently exist for supply methods. PMID:9050186

  6. Evaluating contraceptive choice through the method-mix approach

    Microsoft Academic Search

    R Baveja; K Buckshee; K Das; S. K Das; M. N Hazra; S Gopalan; A Goswami; B. S Kodkany; C. N Sujaya Kumari; K Zaveri; M Roy; S Datey; L. N Gaur; N. K Gupta; R. N Gupta; N. C Saxena; R Singh; Shiv Kumar; S. C Yadav; B. N Saxena

    2000-01-01

    The method-mix approach was used to evaluate informed contraceptive choices in the present study. A total of 8,077 potential clients were given a balanced presentation of all available contraceptive methods in the national program, ie, the CuT 200 intrauterine device (IUD), low-dose combined oral pills (OC), condom, and sterilization (female\\/male) along with a new method, Norplant®.1 The majority of women

  7. [A difficult and delicate task: prescribing contraception for adolescents].

    PubMed

    Abranches, A D

    1993-03-15

    The choice of the most appropriate contraceptive method, when its use is begun, and the motivation of adolescents to use it, are significant factors in adolescent contraceptive continuation. The contraceptive method must suit the personality of the adolescents, who are insecure in most cases, less stable emotionally, rebellious, and uninformed. This pattern can induce constant changes of partners, and accidental and unpredictable sexual activity. Since adolescence is a period of biological and psychological transformation, the contraceptive must be highly effective, safe, and well-tolerated, so that its side effects should not prejudice the continuation of its use. The behavioral contraceptive methods, coitus interruptus, ovulation, and sympto-thermal methods, are contraindicated for adolescents because of their low effectiveness and the requirement of a great deal of discipline. The condom, diaphragm, and spermicides can prevent sexually transmitted diseases, thus they are optimal for adolescents. Their effectiveness is higher than that of behavioral methods but could be better, and they require a certain discipline, which limits sexual spontaneity. The IUD is contraindicated in adolescents and in women who have never given birth, because of the possibilities of pelvic inflammation resulting in pain and bleeding and expulsion of the IUD. The use of hormonal contraception is recommended only two years after the first menstruation, for fear of interference in the biological development of the adolescent. Recent studies have shown that modern low-dose oral contraceptives (OCs) do not exert harmful effects on the adolescent organism. While paying heed to contraindications, OCs can be indicated for this age group. Hormonal contraceptives are effective, safe, and well-tolerated by the majority of patients. They regulate menstruation, and provide beneficial effects such as the reduction of dysmenorrhea and the protection against pelvic inflammatory diseases, benign diseases of the breast, and even uterine and ovarian cancer. PMID:12318748

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

    Microsoft Academic Search

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

    2003-01-01

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

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

    PubMed Central

    2014-01-01

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

  10. Vaginal ring delivery of selective progesterone receptor modulators for contraception.

    PubMed

    Jensen, Jeffrey T

    2013-03-01

    Vaginal ring delivery of selective progesterone receptor modulators (SPRMs) is under development to address the limitations of current hormonal methods that affect use and effectiveness. This method would be appropriate for use in women with contraindications to, or preferences to avoid, estrogens. A contraceptive vaginal ring (CVR) also eliminates the need for daily dosing and therefore might improve the effectiveness of contraception. The principal contraceptive effect of SPRMs is the suppression of ovulation. One limiting factor of chronic SPRM administration is the development of benign endometrial thickening characterized as PRM-associated endometrial changes. Ulipristal acetate (UPA) is approved for use as an emergency contraceptive pill, but no SPRM is approved for regular contraception. The Population Council is developing an ulipristal acetate CVR for regular contraception. The CVR studied is of a matrix design composed of micronized UPA mixed in a silicone rubber matrix The target product is a ring designed for continuous use over 3 months delivering near steady-state drug levels that will suppress ovulation. Results from Phase 1 and 2 studies demonstrate that suppression of ovulation occurs with UPA levels above 6-7 ng/mL. PMID:23040126

  11. Active-Learning Instruction on Emergency Contraception Counseling

    PubMed Central

    Young, Shardae; Vest, Kathleen

    2013-01-01

    Objective. To increase pharmacy students’ knowledge of and confidence in counseling patients regarding emergency contraception and to identify any barriers to counseling patients about emergency contraception. Design. Approximately 200 third-year pharmacy students participated in the Women’s Health Therapeutics workshop at Midwestern University Chicago College of Pharmacy. Students observed a 5-minute skit of a counseling session on emergency contraception and then were asked to pair up with a classmate and practice counseling each other regarding the use of emergency contraception following a checklist of key points. Assessment. One hundred eighty-nine students completed pre- and post-workshop survey instruments. Students’ knowledge scores increased from 86% to 93% (p<0.001). Approximately 25% of the students stated they were confident in counseling patients on emergency contraception before completing the active-learning exercise compared to 58.5% after (p<0.001). The most common barrier to counseling that students identified on the pre- and post-workshop survey was lack of knowledge. Conclusion. Participation in an active-learning exercise significantly increased pharmacy students’ knowledge of and confidence in counseling patients regarding emergency contraception and significantly reduced several barriers to counseling identified prior to participation. PMID:23788815

  12. Vaginal ring delivery of selective progesterone receptor modulators for contraception

    PubMed Central

    Jensen, Jeffrey T.

    2013-01-01

    Vaginal ring delivery of selective progesterone receptor modulators (SPRMs) are under development to address limitations of current hormonal methods that affect use and effectiveness. This method would be appropriate for use in women with contraindications to, or preferences to avoid, estrogens. A contraceptive vaginal ring (CVR) also eliminates the need for daily dosing, and therefore might improve the effectiveness of contraception. The principle contraceptive effect of SPRMs is the suppression of ovulation. One limiting factor of chronic SPRM administration is the development of benign endometrial thickening characterized as PRM-associated endometrial changes. Ulipristal acetate is approved for use as an emergency contraceptive pill, but no SPRM is approved for regular contraception. The Population Council is developing an ulipristal acetate CVR for regular contraception. The CVR studied is of a matrix design composed of micronized UPA mixed in a silicone rubber matrix The target product is a ring designed for continuous use over 3 months delivering near steady-state drug levels that will suppress ovulation. Results from Phase 1–2 studies demonstrate that suppression of ovulation occurs with UPA levels above 6–7 ng/mL. PMID:23040126

  13. Clinical pharmacokinetic interactions between antiepileptic drugs and hormonal contraceptives

    PubMed Central

    Reddy, Doodipala Samba

    2010-01-01

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

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

    PubMed Central

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

    2013-01-01

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

  15. Oral contraceptives after myomectomy: a short term trial.

    PubMed

    Luisi, Stefano; Ciani, Valentina; Gabbanini, Massimo; Sollazzi, Sofia; Torricelli, Michela; Calonaci, Francesco; Petraglia, Felice

    2009-01-01

    Following myomectomy the rate of fertility is restored and pregnancy may be attempted with a good outcome. In the present study a 3 month treatment with OCs in a group of women after a myomectomy was evaluated. The drug compliance and side effects, the benefits of OC in order to reduce symptoms, to increase post-surgical hemoglobin levels and to avoid an early pregnancy after myomectomy were analyzed. A group of women (n = 55) each with myoma >/=5 cm was recruited: they presented menorrhagia, pelvic pain, dyspareunia and dysmenorrhae. After laparotomic myomectomy the women were divided into 3 groups. Group 1: women (n = 16) treated with pill A (15 mcg of ethynilestradiol + 60 mcg of gestodene); group 2: women (n = 23) treated with pill B (20 mcg of ethynilestradiol + 100 mcg of levonorgestrel); group 3: women (n = 16) treated with a placebo (oral calcium). After three months from myomectomy and treatment patients in each group reported a reduced menorrhagia, dismenorrhea and pelvic pain. Serum haemoglobin levels increased in all women (P < .05). No pregnancy occurred in any group and the compliance was good. A post surgery treatment by using oral contraceptives guarentees pregnancy prevention, associated with reduction of pain, and improvement of haematologic conditions. PMID:19946429

  16. Marital Processes, Arranged Marriage, and Contraception to Limit Fertility

    PubMed Central

    Ghimire, Dirgha J.; Axinn, William G.

    2013-01-01

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

  17. Effectiveness and acceptability of progestogens in combined oral contraceptives – a systematic review

    PubMed Central

    Kulier, Regina; Helmerhorst, Frans M; Maitra, Nandita; Gülmezoglu, A Metin

    2004-01-01

    Background The progestogen component of oral contraceptives (OCs) has undergone changes since it was recognized that their chemical structure can influence the spectrum of minor adverse and beneficial effects. Methods The objective of this review was to evaluate currently available low-dose OCs containing ethinylestradiol and different progestogens in terms of contraceptive effectiveness, cycle control, side effects and continuation rates. The Cochrane Controlled Trials Register, MEDLINE and EMBASE databases were searched. Randomized trials reporting clinical outcomes were considered for inclusion and were assessed for methodological quality and validity. Results Twenty–two trials were included in the review. Eighteen were sponsored by pharmaceutical companies and in only 5 there was an attempt for blinding. Most comparisons between different interventions included one to three trials, involving usually less than 500 women. Discontinuation was less with second-generation progestogens compared to first–generation (RR 0.79; 95% CI 0.69–0.91). Cycle control appeared to be better with second-compared to first-generation progestogens for both, mono-and triphasic preparations (RR 0.69; 95% CI 0.52–0.91) and (RR 0.61; 95% CI 0.43–0.85), respectively. Intermenstrual bleeding was less with third- compared to second-generation pills (RR 0.71; 95% CI 0.55–0.91). Contraceptive effectiveness of gestodene (GSD) was comparable to that of levonorgestrel (LNG), and had similar pattern of spotting, breakthrough bleeding and absence of withdrawal bleeding). Drospirenone (DRSP) was similar compared to desogestrel (DSG) regarding contraceptive effectiveness, cycle control and side effects. Conclusion The third- and second-generation progestogens are preferred over first generation in all indices of acceptability. Current evidence suggests that GSD is comparable to LNG in terms of contraceptive effectiveness and for most cycle control indices. GSD is also comparable to DSG. DRSP is comparable to DSG. Future research should focus on independently conducted well designed randomized trials comparing particularly the third- with second-generation progestogens. PMID:15357865

  18. Elevated 12-Month and Lifetime Prevalence and Comorbidity Rates of Mood, Anxiety, and Alcohol Use Disorders in Chinese Men Who Have Sex with Men

    PubMed Central

    Yu, Lianzheng; Jiang, Chao; Na, Jun; Li, Ning; Diao, Wenli; Gu, Yuan; Zhao, Li; Zou, Yan; Chen, Ying; Liu, Li; Mu, Huijuan; Liu, Yunyong; Yu, Liya; Yang, Xiaoli; Pan, Guowei

    2013-01-01

    Background This study aimed to assess whether Chinese men who have sex with men (MSM) had a significantly elevated prevalence of psychiatric disorders compared to urban males in China. Methods 807 MSM were recruited using a respondent-driven sampling (RDS) method in urban area of northeast China. Psychiatric disorders were assessed employing the Composite International Diagnostic Interview (CIDI. Version 1.0) according to the criteria of the DSM-III-R. Results Chinese MSM had a significantly elevated standardized prevalence ratios (SPR) for lifetime prevalence of any disorder (SPR?=?2.8; 95%CI: 2.5–3.2), mood disorder (SPR?=?3.0; 95%CI: 2.3–3.7), anxiety disorder (SPR?=?5.5; 95% CI: 4.6–6.5), alcohol use disorder (SPR?=?2.4, 95%CI: 2.0–2.8), and combination of disorders (SPR?=?4.2; 95%CI: 3.4–5.1). Conclusions Chinese MSM had significantly elevated prevalence and comorbidity of psychiatric disorders. RDS is a suitable sampling method for psychiatric epidemiological survey in MSM population. PMID:23637731

  19. The effect of follow-up visits or contacts after contraceptive initiation on method continuation and correct use?

    PubMed Central

    Steenland, Maria W.; Zapata, Lauren B.; Brahmi, Dalia; Marchbanks, Polly A.; Curtis, Kathryn M.

    2015-01-01

    Background We conducted a systematic review to assess whether follow-up visits or contacts after a woman begins using contraception improve method continuation and correct use. Study Design We searched the PubMed database for all peer-reviewed articles in any language published from database inception through May 2012 that examined the effect of a structured follow-up schedule of visits or contacts on contraceptive use. We included studies that compared women who initiated a method of contraception with a certain follow-up schedule compared to women with a different follow-up schedule or no follow-up at all. To be included, studies must have compared groups on a measure of contraceptive use (e.g., pregnancy, correct use, consistent use, method discontinuation including expulsion). Though not ideally suited to answer our review question, studies in which women used a variety of contraceptive methods but results were not stratified by method type were included. Results Four studies met our inclusion criteria (Level I, poor to II-2, poor). Two studies examined the effect of a specific follow-up visit schedule on intrauterine device (IUD) continuation: one examining frequency of visits and one examining the timing of the first follow-up visit. Women with more frequent follow-up visits did not have a statistically significant difference in proportion of removals for medical reasons compared with women who had fewer follow-up visits; among women who had their IUDs removed for medical reasons, those who had more frequent follow-up visits had a longer mean time of use prior to removal. The other study found more removals and shorter continuation among women with a follow-up visit at 1 week compared to women with a follow-up visit at 1 month after IUD insertion (no statistical tests reported). Two studies examined the effect of follow-up phone calls compared to no follow-up phone calls after an initial family planning visit among adolescents initiating a variety of contraceptive methods. Neither of the two studies found any differences in method continuation or correct use between study groups. Conclusions It is difficult to determine what effect, if any, follow-up visits or contacts have on contraceptive method continuation or correct use. Few studies were identified, and those that were identified were mostly of poor quality, were not method specific and had either poor patient compliance with follow-up visits or poor phone contact completion rates. PMID:23114736

  20. [Forgetting hormonal contraceptive methods: expert opinion about their daily management in clinical routine practice].

    PubMed

    Jamin, C; André, G; Audebert, A; Christin-Maître, S; Elia, D; Harvey, T; Letombe, B; Lopes, P; Moreau, C; Nisand, I; Pélissier, C

    2011-11-01

    Many guidelines regarding the daily management of regular oral hormonal contraceptive methods have been proposed worldwide. Some of them may even appear to be conflicting. The search for the maximal contraceptive protection leads to a low acceptance of these guidelines, probably because of their complexity and their apparent discrepancy. We are deeply convinced that simplicity and pragmatism of guidelines should pave the way to both their better acceptance and compliance and, consequently, to their improved real-life effectiveness. We have considered physiology and pharmacodynamics before proposing the following rules for an effective management of hormonal contraceptive failures. We conclude that the risk of unwanted pregnancy is higher in case of a unique contraception misuse/a delayed start during the first week of the contraceptive cycle (or in case of multiple days of contraceptive misuses during the following weeks) for a combined contraception or at every cycle day for a non anti-ovulatory progestin only contraception. In such risky situations, we firmly recommend the restart of the regular contraceptive method and the use of condoms for the following 72 hours, provided no sexual intercourse has occurred during the past 5 days before the contraceptive failure. If sexual intercourse has occurred during the past 5 days before the contraceptive failure, we firmly recommend the intake of an emergency contraception, ulipristal acetate, the restart the regular contraceptive method and in this case, the use of condoms for, at least, the following 7 days. PMID:22000833

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

    PubMed

    Gross, Tal; Lafortune, Jeanne; Low, Corinne

    2014-01-01

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

  2. Contraceptive development lags in U.S.

    PubMed

    Meade, V

    1990-05-01

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

  3. Benefits and risks of oral contraceptives.

    PubMed

    Drife, J

    1990-12-01

    Like all drugs, combined oral contraceptives (COCs) have side effects that may be harmful or beneficial. During the last 20 years their adverse effects have been fully reported, but their benefits have been largely ignored. Most of the benefits of COCs result from the suppression of ovulation. This means that the advantages they confer are not dose-dependent, provided that ovarian activity is effectively suppressed. The most important health benefit of COCs worldwide is the effective prevention of pregnancy, which carries high risks in developing countries and has a mortality as high as 1 in 150 in Africa. The risk of ectopic pregnancy is reduced by 90% in COC-users compared with women using no contraception. The COC prevents the repeated proliferation of ovarian and endometrial tissue that takes place in the menstrual cycle, and it is therefore not surprising that it reduces the risk of ovarian and endometrial malignancy. What is surprising is that a relative risk of 0.6 for these cancers can be detected after only 12 months or less of COC use, and persists for at least 15 years after the COC is stopped. The COC reduces the incidence of benign breast disease, though not the types of disease linked with breast cancer. It considerably reduces the incidence of benign ovarian cysts, and this has been calculated to avoid 28 operations for functional ovarian cysts per 100,000 pill users every year. The risk of uterine fibroids is reduced by 17% with every five years of COC use. By thickening the cervical mucus, the COC reduces the risk of pelvic inflammatory disease by about 50%. By inhibiting growth and development of the endometrium it reduces the incidence of menorrhagia and consequently iron-deficiency anaemia, and it produces a 40% reduction in the frequency of dysmenorrhoea. Unlike the benefits of the COC, its risks appear to be to some extent dose-dependent. The first serious risk to be discovered was a three- to six-fold increase in venous thromboembolism, which is probably an oestrogen effect and disappears quickly when the COC is stopped. The COC doubles the risk of haemorrhagic stroke, this risk is related to smoking and hypertension, unlike the increased risk of thrombotic stroke. The risk of myocardial infarction is related to smoking and age, and COCs are contraindicated over the age of 35 in smokers though not necessarily in non-smokers. Much of this information, however, is based on studies involving older high-dose COCs. Risks may well be lower with modern COCs, but firm data are lacking.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:2291444

  4. Gossypol as an oral contraceptive for men.

    PubMed

    1980-01-01

    Gossypol is a phenolic compound isolated from the seeds, stems, and roots of the cotton plant. The chemical has been known for years as the toxic principle left in the cottonseed cake after cottonseed oil extraction. It is also present in the cold pressed cottonseed oil from which it may be removed through reactions with alkali. Extremely low birthrates in China's Hebeth province were traced to the use of crude cotton seed oil for cooking purposes. After prolonged investigation, it was determined that male infertility was related to the gossypol content of the oil. After a short period of animal studies, the Chinese in 1972 undertook widespread clinical trials of gossypol as a contraceptive agent. Over 4000 men have undergone treatment with the drug, some for as long as 4 years. Infertility resulted after 2 months of a daily dose of 20 mg and then the participants were maintained on 150-220 mg/month in divided doses. The drug apparently did not decrease libido in most test subjects and had not been reported to impair potency. Semen analysis at various intervals showed a decrease in motile sperm, malformed spermatozoa, and then a decrease in sperm count, leading to azoospermia. On discontinuation of the substance, the antifertility effect completely reversed itself within 3 months. No obvious toxic effects of pathological changes were observed in human and animal studies. Levels of luteinizing hormone and testosterone were unchanged and apparently indicated that gossypol does not affect hormonal balances. Adverse reactions reported to date include transient and reversible weakness in 10% of the test subjects on initiation of therapy. In addition, appetite changes, gastric discomfort, and nausea have been noted. A few cases of slight EKG changes and disturbances in potassium metabolism have occurred. No chromosomal changes have been observed nor have tests shown any mutagenic effects of the drug. In conclusion, preliminary data indicated that gossypol may offer an excellent new approach to contraception. Further testing is required to elucidate the drug's mechanism of action and to determine its adverse and possible toxic effects. PMID:6928215

  5. Epidemiology of hormonal contraceptives-related venous thromboembolism.

    PubMed

    Hugon-Rodin, Justine; Gompel, Anne; Plu-Bureau, Geneviève

    2014-12-01

    For many years, it has been well documented that combined hormonal contraceptives increase the risk of venous thromboembolism (VTE). The third-generation pill use (desogestrel or gestodene (GSD)) is associated with an increased VTE risk as compared with second-generation (levonorgestrel) pill use. Other progestins such as drospirenone or cyproterone acetate combined with ethinyl-estradiol (EE) have been investigated. Most studies have reported a significant increased VTE risk among users of these combined oral contraceptives (COCs) when compared with users of second-generation pills. Non-oral combined hormonal contraception, such as the transdermal patch and the vaginal ring, is also available. Current data support that these routes of administration are more thrombogenic than second-generation pills. These results are consistent with the biological evidence of coagulation activation. Overall, the estrogenic potency of each hormonal contraceptive depending on both EE doses and progestin molecule explains the level of thrombotic risk. Some studies have shown a similar increased VTE risk among users of COCs containing norgestimate (NGM) as compared with users of second-generation pill. However, for this combination, biological data, based on quantitative assessment of sex hormone-binding globulin or haemostasis parameters, are not in agreement with these epidemiological results. Similarly, the VTE risk associated with low doses of EE and GSD is not biologically plausible. In conclusion, newer generation formulations of hormonal contraceptives as well as non-oral hormonal contraceptives seem to be more thrombogenic than second-generation hormonal contraceptives. Further studies are needed to conclude on the combinations containing NGM or low doses of EE associated with GSD. PMID:25012200

  6. Influence of combined oral contraceptives on the periodontal condition

    PubMed Central

    DOMINGUES, Roberta Santos; FERRAZ, Bruna Fidêncio Rahal; GREGHI, Sebastião Luiz Aguiar; de REZENDE, Maria Lúcia Rubo; PASSANEZI, Euloir; SANT'ANA, Adriana Campos Passanezi

    2012-01-01

    Most studies investigating the impact of oral contraceptives have been performed some years ago, when the level of sexual hormones was greater than the actual formulations. Objective The aim of this study was to evaluate the effects of current combined oral contraceptives (COC) on periodontal tissues, correlating the clinical parameters examined with the total duration of continuous oral contraceptive intake. Material and methods Twenty-five women (19-35 years old) taking combined oral contraceptives for at least 1 year were included in the test group. The control group was composed by 25 patients at the same age range reporting no use of hormone-based contraceptive methods. Clinical parameters investigated included pocket probing depth (PD), clinical attachment level (CAL), sulcular bleeding index (SBI) and plaque index (Pl.I). Data were statistically evaluated by unpaired t test, Pearson's correlation test and Spearman's correlation test. Results The test group showed increased PD (2.228±0.011 x 2.154±0.012; p<0.0001) and SBI (0.229±0.006 x 0.148±0.005, p<0.0001) than controls. No significant differences between groups were found in CAL (0.435±0.01 x 0.412±0.01; p=0.11). The control group showed greater Pl.I than the test group (0.206±0.007 x 0.303±0.008; p<0.0001). No correlation between the duration of oral contraceptive intake, age and periodontal parameters was observed. Conclusions These findings suggest that the use of currently available combined oral contraceptives can influence the periodontal conditions of the patients, independently of the level of plaque accumulation or total duration of medication intake, resulting in increased gingival inflammation. PMID:22666846

  7. Midwives' adoption of the reproductive life plan in contraceptive counselling: a mixed methods study

    PubMed Central

    Stern, J.; Bodin, M.; Grandahl, M.; Segeblad, B.; Axén, L.; Larsson, M.; Tydén, T.

    2015-01-01

    STUDY QUESTION How is the reproductive life plan (RLP) adopted in midwifery contraceptive counselling? SUMMARY ANSWER A majority of midwives adopted the RLP in their counselling, had predominantly positive experiences and considered it a feasible tool for promoting reproductive health. WHAT IS KNOWN ALREADY The RLP is a health-promoting tool recommended by the Centers for Disease Control and Prevention in the USA for improving preconception health. It was recently used in a clinical setting in Sweden and was found to increase women's knowledge about fertility and to influence women's wishes to have their last child earlier in life. STUDY DESIGN, SIZE, DURATION An exploratory mixed methods study among 68 midwives who provided contraceptive counselling in primary health care to at least 20 women each during the study period. Midwives received an introduction and materials for using the RLP in contraceptive counselling. Three months later, in the spring of 2014, they were invited to complete a questionnaire and participate in a focus group interview about their adoption of the RLP. PARTICIPANTS/MATERIALS, SETTING, METHODS Data collection was through a questionnaire (n = 53 out of 68; participation rate 78%) and five focus group interviews (n = 22). Participants included both younger and older midwives with longer and shorter experiences of contraceptive counselling in public and private health care in one Swedish county. Quantitative data were analysed for differences between users and non-users, and qualitative data were analysed by qualitative content analysis to explore the midwives experiences and opinions of using the RLP. MAIN RESULTS AND THE ROLE OF CHANCE Sixty-eight per cent of midwives had used the RLP in their contraceptive counselling. Four categories emerged through the focus group interviews: (i) A predominantly positive experience; (ii) The RLP—a health-promoting tool; (iii) individual and societal factors influence the RLP counselling; and (4) long-term implementation comprises opportunities, risks and needs. The most common reason for not using the RLP was lack of information. LIMITATIONS, REASONS FOR CAUTION There was general lack of experience of using the RLP with women from different cultural backgrounds, with non-Swedish speaking women and, when a partner was present. Due to the non-random sample, the limited knowledge about non-responders and a short follow-up period, results apply to short-term implementations and might not fully apply to long-term implementation. WIDER IMPLICATIONS OF THE FINDINGS The use of RLP in contraceptive counselling appears a feasible way of promoting reproductive health. Results from the USA and Sweden indicate it is a promising tool for midwives and other health professionals involved in reproductive counselling, which deserves to be explored in other nations. STUDY FUNDING/COMPETING INTEREST(S) Grants were received from the Medical Faculty at Uppsala University and the European Society of Contraception and Reproductive Health. There are no competing interests. TRIAL REGISTRATION NUMBER N/A. PMID:25771220

  8. The cervical cap as a barrier contraceptive.

    PubMed

    Cagen, R

    1986-05-01

    This report covers the 1st 4 years (beginning in 1984) of a Food and Drug Administration-approved study of use of the cervical cap as a contraceptive device. The cap used in this study is the Prentif Cavity-Rim Cervical Cap. 620 women were issued cervical caps. They ranged in age from 16 to 43 years. 97.7% had attained a high school diploma and 57.3% had at least an undergraduate college education. Each woman was instructed carefully on proper placement and use of the cervical cap. Terminal problems appear most frequently during the 1st 9 months of cap usage. Terminal problems most frequently mentioned include 1) unplanned pregnancy, 2) partner discomfort, 3) dislodgement and 4) lack of confidence. Out of 620 women, there were 92 unplanned pregnancies during the 4-year period. At least 45 of 86 pregnancies were associated with user failure (6 of the 92 were not sure whether their pregnancies occurred before or after being fitted for the cap.). 4 of the 620 developed an abnormal Papanicolaou smear. This figure is within the expected range of women in any sample who would develop an abnormal Papanicolaou smear. Odor was the most frequently mentioned problem (2.9%). 80.53% of the participants continued to use the cervical cap after 1 year. Comfort and convenience were 2 positive reasons mentioned for continuing use of the cap. Motivation is the most important factor associated with the success of the cap. PMID:3757513

  9. Emergency contraception: potential role of ulipristal acetate.

    PubMed

    Gemzell-Danielsson, Kristina; Meng, Chun-Xia

    2010-01-01

    Unintended pregnancy is a global reproductive health problem. Emergency contraception (EC) provides women with a safe means of preventing unwanted pregnancies after having unprotected intercourse. While 1.5 mg of levonorgestrel (LNG) as a single dose or in 2 doses with 12 hours apart is the currently gold standard EC regimen, a single dose of 30 mg ulipristal acetate (UPA) has recently been proposed for EC use up to 120 hours of unprotected intercourse with similar side effect profiles as LNG. The main mechanism of action of both LNG and UPA for EC is delaying or inhibiting ovulation. However, the 'window of effect' for LNG EC seems to be rather narrow, beginning after selection of the dominant follicular and ending when luteinizing hormone peak begins to rise, whereas UPA appears to have a direct inhibitory effect on follicular rupture which allows it to be also effective even when administered shortly before ovulation, a time period when use of LNG is no longer effective. These experimental findings are in line with results from a series of clinical trials conducted recently which demonstrate that UPA seems to have higher EC efficacy compared to LNG. This review summarizes some of the data available on UPA used after unprotected intercourse with the purpose to provide evidence that UPA, a new type of second-generation progesterone receptor modulator, represents a new evolutionary step in EC treatment. PMID:21072297

  10. Change in the Prevalence of HIV-1 and the Rate of Transmitted Drug-Resistant HIV-1 in Haiphong, Northern Vietnam.

    PubMed

    Pham, Hung Viet; Ishizaki, Azumi; Nguyen, Cuong Hung; Saina, Matilda Chelimo; Hoang, Huyen Thi Thanh; Tran, Vuong Thi; Bi, Xiuqiong; Pham, Thuc Van; Ichimura, Hiroshi

    2015-07-01

    We previously reported a significant decrease in HIV-1 prevalence, with no increase in drug-resistant HIV-1 among injecting drug users (IDU), female sex workers (FSW), and blood donors (BD), in Haiphong, Vietnam, from 2007 to 2009. In 2012, 388 IDU, 51 FSW, and 200 BD were recruited for further analysis. None had a history of antiretroviral treatment. From 2007 to 2012, HIV-1 prevalence was reduced from 35.9% to 18.6% (p<0.001), 23.1% to 9.8% (p<0.05), and 2.9% to 1% (p=0.29) in IDU, FSW, and BD, respectively. Of 79 anti-HIV-1 antibody-positive samples, 61 were successfully analyzed for the pol-reverse transcriptase (RT) region. All HIV-1 strains were CRF01_AE. Nonnucleoside RT inhibitor-resistant mutations, Y181C/I, were detected in three subjects; one had the nucleoside RT inhibitor-resistant mutations L74V and M184V and one had E138K. The prevalence of transmitted drug-resistant HIV-1 in Haiphong increased slightly from 1.8% in 2007 to 6.6% in 2012 (p=0.06). PMID:25970090

  11. Contraception before and after termination of pregnancy: can we do it better?

    Microsoft Academic Search

    Felicity Goodyear-Smith; Bruce Arroll

    Aim To compare contraceptive use pre- and post-therapeutic abortion in 1995, 1999 and 2002 in a New Zealand clinic. Methods Retrospective, consecutive case review of women presenting for therapeutic abortion. Anonymous data included demographic details, contraception used at conception, and post-termination contraception. Results Pre-conception contraceptive use is significantly declining, with post- termination condom choice increasing. This is predominantly due to

  12. Peri-abortion contraceptive care: Can we reduce the incidence of repeat abortions?

    Microsoft Academic Search

    Malini Garg; Madan Singh; Diana Mansour

    2001-01-01

    IntroductionIt is of great importance for repeat unwanted pregnancies to be prevented rather than aborted. We therefore sought to: determine the reasons for contraceptive failure in women seeking repeat abortions; audit the peri-abortion contraception services offered at our hospital, and make recommendations regarding peri-abortion contraception services based on the above findings.MethodA self-administered questionnaire was used to determine the contraceptive practices

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

    PubMed Central

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

    2010-01-01

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

  14. Contraceptive effects of extended lactational amenorrhoea: beyond the Bellagio Consensus.

    PubMed

    Short, R V; Lewis, P R; Renfree, M B; Shaw, G

    1991-03-23

    We have recorded the duration of lactational anovulation and amenorrhoea in a well-nourished group of Australian women who breastfed their babies throughout the study. The data enabled us to compare the theoretical cumulative probability of conception among breastfeeding women who had unprotected intercourse irrespective of their menstrual status with that of those who had unprotected intercourse only during lactational amenorrhoea. Breastfeeding alone is not an effective form of contraception, since all the women in our study resumed normal ovulation while still breastfeeding. However, among women who have unprotected intercourse only during lactational amenorrhoea but adopt other contraceptive measures when they resume menstruation, only 1.7% would have become pregnant during the first 6 months of amenorrhoea, only 7% after 12 months, and only 13% after 24 months. Thus for our women it would be possible to extend the Bellagio Consensus Conference guidelines which stated that lactational amenorrhoea can only be relied on as a contraceptive for the first 6 months post-partum in women who are fully or almost fully breastfeeding. The lactational amenorrhoea method can be relied on for excellent contraceptive protection in the first 6 months of breastfeeding, irrespective of when supplements are introduced into the baby's diet; for women who continue to breastfeed the method can also give good protection for up to 12 months post partum. Once menstruation has returned, other forms of contraception are essential to prevent pregnancy. PMID:1672186

  15. Milestones in contraceptive vaccines development and hurdles in their application.

    PubMed

    Gupta, Satish Kumar; Shrestha, Abhinav; Minhas, Vidisha

    2014-01-01

    Contraceptive vaccines have been proposed for controlling the growing human population and wildlife population management. Multiple targets such as gonadotropin releasing hormone (GnRH), luteinizing hormone, follicle stimulating hormone, gonadotropin receptors, sperm-specific proteins and zona pellucida glycoproteins have been exploited to develop contraceptive vaccine and their efficacy investigated and shown in various experimental animal models. Vaccines based on GnRH have found application in immuno-castration of male pigs for prevention of boar-taint. Vaccines based on zona pellucida glycoproteins have shown promising results for population management of wild horses and white-tailed deer. Phase II clinical trials in women with ?-human chorionic gonadotropin (?-hCG)-based contraceptive vaccine established proof of principle that these can be developed for human application. Block in fertility by ?-hCG contraceptive vaccine was reversible. Further research inputs are required to establish the safety of contraceptive vaccines, improve their immunogenicity and to develop novel vaccine delivery platforms for providing long lasting immunity. PMID:24262991

  16. Post-abortion depot medroxyprogesterone acetate continuation rates: a randomized trial of cyclic estradiol

    Microsoft Academic Search

    Alisa B. Goldberg; Lilia H. Cardenas; Alan E. Hubbard; Philip D. Darney

    2002-01-01

    Irregular menstrual bleeding is a common reason for discontinuation of depot medroyprogesterone acetate (DMPA) contraception. We conducted a double-blind, randomized placebo controlled trial to estimate if transdermal estradiol used in a cyclic fashion could make DMPA bleeding patterns more acceptable and improve DMPA continuation rates. Women initiating DMPA contraception immediately post-abortion (N = 132) were randomized to receive either a

  17. Hormonal Contraception Is Associated with a Reduced Risk of Bacterial Vaginosis: A Systematic Review and Meta-Analysis

    PubMed Central

    Vodstrcil, Lenka A.; Hocking, Jane S.; Law, Matthew; Walker, Sandra; Tabrizi, Sepehr N.; Fairley, Christopher K.; Bradshaw, Catriona S.

    2013-01-01

    Objective To examine the association between hormonal contraception (HC) and bacterial vaginosis (BV) by systematic review and meta-analysis. Methods Medline, Web of Science and Embase databases were searched to 24/1/13 and duplicate references removed. Inclusion criteria 1) >20 BV cases; 2) accepted BV diagnostic method; 3) measure of HC-use either as combined oestrogen-progesterone HC (combined), progesterone-only contraception (POC) or unspecified HC (u-HC); 4) ?10% of women using HC; 5) analysis of the association between BV and HC-use presented; 6) appropriate control group. Data extracted included: type of HC, BV diagnostic method and outcome (prevalent, incident, recurrent), and geographical and clinic-setting. Meta-analyses were conducted to calculate pooled effect sizes (ES), stratified by HC-type and BV outcome. This systematic review is registered with PROSPERO (CRD42013003699). Results Of 1713 unique references identified, 502 full-text articles were assessed for eligibility and 55 studies met inclusion criteria. Hormonal contraceptive use was associated with a significant reduction in the odds of prevalent BV (pooled effect size by random-effects [reES]?=?0.68, 95%CI0.63–0.73), and in the relative risk (RR) of incident (reES?=?0.82, 95%CI:0.72–0.92), and recurrent (reES?=?0.69, 95%CI:0.59–0.91) BV. When stratified by HC-type, combined-HC and POC were both associated with decreased prevalence of BV and risk of incident BV. In the pooled analysis of the effect of HC-use on the composite outcome of prevalent/incident/recurrent BV, HC-use was associated with a reduced risk of any BV (reES?=?0.78, 95%CI:0.74–0.82). Conclusion HC-use was associated with a significantly reduced risk of BV. This negative association was robust and present regardless of HC-type and evident across all three BV outcome measures. When stratified by HC-type, combined-HC and POC were both individually associated with a reduction in the prevalence and incidence of BV. This meta-analysis provides compelling evidence that HC-use influences a woman’s risk of BV, with important implications for clinicians and researchers in the field. PMID:24023807

  18. Repeated use of hormonal emergency contraception by younger women in the UK

    Microsoft Academic Search

    Sam Rowlands; Hassy Devalia; Ross Lawrenson; John Logie; Bernard Ineichen

    2000-01-01

    A cohort of women aged 14–29 in 1993 was identified from the General Practice Research Database and followed up for a period of 4 years. Patient files were searched for evidence of use of emergency contraception and regular contraception. Of the 95 007 women, 15 105 (16%) had received emergency contraception during the study period (an average of 5% per

  19. Emergency contraception: Lack of awareness among patients presenting for pregnancy termination

    Microsoft Academic Search

    M. A. Jamieson; S. P. Hertweck; J. S. Sanfilippo

    1999-01-01

    Study ObjectiveEmergency contraception, otherwise known as postcoital contraception, refers to a group of birth control modalities that, when used after unprotected intercourse within defined time constraints, can markedly reduce the risk of a resultant unintended pregnancy. The English literature, using British and American awareness data, consistently claims that these contraceptive options are underutilized in the United States because of a

  20. Emergency contraception: Advance provision in a young, high-risk clinic population

    Microsoft Academic Search

    Tina Raine; Cynthia Harper; Kathleen Leon; Philip Darney

    2000-01-01

    Objective: To assess whether advance provision of emergency contraception increases its use and whether it has secondary effects on regular contraceptive use.Methods: We conducted a controlled trial of female clients, aged 16–24 years, who attended a publicly funded family planning clinic. Women were systematically assigned to receive an advance provision of emergency contraception and education (treatment) or education only (control).

  1. Differences between users and non-users of emergency contraception after a recognized unprotected intercourse

    Microsoft Academic Search

    Morten Beck Sørensen; Beth Lilja Pedersen; Lone Enslev Nyrnberg

    2000-01-01

    Knowledge of emergency contraception is crucial but might not transform into use. Factors influencing decision-making related to use of emergency contraception after an unprotected intercourse and the characteristics of users of emergency contraception (EC) were assessed. In an abortion clinic setting, 217 women referred for termination of pregnancy were asked to fill in a questionnaire. Of the 217 women, 139

  2. PROFILE OF INTRAUTERINE CONTRACEPTIVE DEVICE ACCEPTORS AT THE UNIVERSITY OF UYO TEACHING HOSPITAL, UYO, NIGERIA

    Microsoft Academic Search

    A. M. Abasiattai; E. A. Bassey; E. J. Udoma

    Background: Use of modern contraceptive methods has been shown to reduce unwanted pregnancy, high parity and maternal mortality. Intrauterine contraceptive devices which are among the safest and most effective reversible contraceptives available, are particularly suitable for women in developing countries as they are affordable, convenient to use, do not require re-supply visits and are very cost- effective. The aim of

  3. Knowledge and willingness to use emergency contraception among low-income post-partum women

    Microsoft Academic Search

    Rebecca Jackson; Eleanor Bimla Schwarz; Lori Freedman; Philip Darney

    2000-01-01

    We performed a multivariate analysis to determine factors associated with knowledge and willingness to use emergency contraception in a consecutive sample of 371 post-partum women from an inner-city public hospital. Women were queried about previous contraceptive use, pregnancy history including abortions and unplanned pregnancies, and demographic characteristics. Outcomes included knowledge of emergency contraception and willingness to use it. Questionnaires were

  4. Mass Media, Ideation, and BehaviorA Longitudinal Analysis of Contraceptive Change in the Philippines

    Microsoft Academic Search

    D. LAWRENCE KINCAID

    2000-01-01

    To estimate the impact of a mass media campaign to promote contraceptive use, a national longitudinal sample survey was conducted in September 1995 and March 1996. Recall of at least one television spot was 82.3%. Modern contraceptive use increased 2.1 percentage points. The conditional change regression analysis revealed that prior contraceptive intention and behavior, current ideation, and prior ideation were

  5. Promoting contraceptive use among unmarried female migrants in one factory in Shanghai: a pilot workplace intervention

    Microsoft Academic Search

    Xu Qian; Helen Smith; Wenyuan Huang; Jie Zhang; Ying Huang; Paul Garner

    2007-01-01

    BACKGROUND: In urban China, more single women are becoming pregnant and resorting to induced abortion, despite the wide availability of temporary methods of contraception. We developed and piloted a workplace-based intervention to promote contraceptive use in unmarried female migrants working in privately owned factories. METHODS: Quasi-experimental design. In consultation with clients, we developed a workplace based intervention to promote contraception

  6. Gendered interests and poor spousal contraceptive communication in Islamic northern Nigeria

    Microsoft Academic Search

    Chimaraoke Izugbara; Latifat Ibisomi; Alex C Ezeh; Mairo Mandara

    2010-01-01

    Relying on focus group discussions and in-depth individual interviews with men and women in Jigawa and Kano states in northern Nigeria, we investigated barriers to spousal contraceptive communication. While attitudes toward spousal contraceptive communication were generally positive, there was very little evidence that respondents engaged in it. Poor spousal contraceptive communication in northern Nigeria is, in many ways, driven by

  7. Contraceptive use and non-use among teenage girls in a sexually motivated situation

    Microsoft Academic Search

    Pia Suvivuo; Kerttu Tossavainen; Osmo Kontula

    2009-01-01

    This qualitative narrative study examined contraceptive use and non-use in light of the Theory of Planned Behaviour. The purpose of this paper was to understand contraceptive use and non-use among Finnish teenage girls: why do girls use or not use contraception in a sexually motivated situation and how do the determinants of the Theory of Planned Behaviour (intention, attitudes, social

  8. Relationships between Contraceptive Behavior and Love Attitudes, Sex Attitudes, and Self-Esteem.

    ERIC Educational Resources Information Center

    Adler, Nancy L.; Hendrick, Susan S.

    1991-01-01

    Identified variables related to contraception that could be addressed during contraceptive counseling and to aid persons in deciding the most effective contraceptive method within context of an intimate relationship. Used questionnaire responses from 350 college students. Results indicated both general self-esteem and sexual self-esteem were…

  9. Psychological and situation?specific correlates of contraceptive behavior among university women

    Microsoft Academic Search

    William A. Fisher; Donn Byrne; Marilyn Edmunds; Carol T. Miller; Kathryn Kelley; Leonard A. White

    1979-01-01

    The current research examined correlates of two contraceptive behaviors among university women: using a campus contraception clinic, and utilizing contraception consistently. On the basis of the Sexual Behavior Sequence (Byrne, 1977), it was proposed that clinic users (versus nonusers) and consistent contraceptors (versus inconsistent contraceptors and sexually inactive subjects) indicate a relatively more positive emotional orientation to sexuality and more

  10. Contraceptive Use and Non-Use among Teenage Girls in a Sexually Motivated Situation

    ERIC Educational Resources Information Center

    Suvivuo, Pia; Tossavainen, Kerttu; Kontula, Osmo

    2009-01-01

    This qualitative narrative study examined contraceptive use and non-use in light of the Theory of Planned Behaviour. The purpose of this paper was to understand contraceptive use and non-use among Finnish teenage girls: why do girls use or not use contraception in a sexually motivated situation and how do the determinants of the Theory of Planned…

  11. Hormonal contraception and risk of sexually transmitted disease acquisition: Results from a prospective study

    Microsoft Academic Search

    Jared M. Baeten; Patrick M. Nyange; Barbra A. Richardson; Ludo Lavreys; Bhavna Chohan; Harold L. Martin; Kishorchandra Mandaliya; Jeckoniah O. Ndinya-Achola; Job J. Bwayo; Joan K. Kreiss

    2001-01-01

    Objectives: To examine the relationship between use of oral contraceptive pills or depot medroxyprogesterone acetate and sexually transmitted disease acquisition. Study Design: Prospective cohort included 948 Kenyan prostitutes. Multivariate Andersen-Gill proportional hazards models were constructed, adjusting for sexual behavioral and demographic variables. Results: When compared with women who were using no contraception, users of oral contraceptive pills were at increased

  12. Serum lipid levels during oral contraceptive and glucocorticoid administration 1

    PubMed Central

    Doar, J. W. H.; Wynn, V.

    1969-01-01

    The effects of oral contraceptives on fasting serum lipid levels have been studied longitudinally in two groups of women. One hundred and twenty-eight subjects (group A) were tested before and during therapy; 52 subjects (group B) were tested initially during therapy and again after this had been discontinued. In both groups oral contraceptive therapy was associated with significantly raised mean serum triglyceride and cholesterol levels. No relation was found between the magnitude of change of serum triglyceride levels and the nature of oestrogen-progestogen combination, age, parity, degree of obesity, family history of diabetes, or duration of therapy. A significant elevation of the mean fasting serum triglyceride level was also found in a group of 19 women receiving low-dose glucocorticoid therapy, though the percentage increase (16%) was less than that in the women receiving oral contraceptives (49%).

  13. Ulipristal acetate, a progesterone receptor modulator for emergency contraception

    PubMed Central

    Jadav, Shilpa P.; Parmar, Dinesh M.

    2012-01-01

    Unwanted pregnancy is a global reproductive health problem. Emergency contraception is defined as the use of drug or device after unprotected or underprotected intercourse to prevent an unwanted pregnancy. 1.5 mg of levonorgestrel as a single dose or in two doses with 12 h apart taken within 72 h of unprotected intercourse is the current gold standard emergency contraception regimen. This method is only effective if used as soon as possible after sexual intercourse and before ovulation. A single dose of 30 mg ulipristal acetate, a novel selective progesterone receptor modulator, has recently been proposed for the emergency contraception use up to 120 h of unprotected intercourse with similar side effect profiles as levonorgestrel. Ulipristal acetate could possibly prevent pregnancy when administered in the advanced follicular phase, even if luteinizing hormone levels have already begun to rise, a time when levonorgestrel is no longer effective in inhibiting ovulation. PMID:22629083

  14. Ulipristal acetate, a progesterone receptor modulator for emergency contraception.

    PubMed

    Jadav, Shilpa P; Parmar, Dinesh M

    2012-04-01

    Unwanted pregnancy is a global reproductive health problem. Emergency contraception is defined as the use of drug or device after unprotected or underprotected intercourse to prevent an unwanted pregnancy. 1.5 mg of levonorgestrel as a single dose or in two doses with 12 h apart taken within 72 h of unprotected intercourse is the current gold standard emergency contraception regimen. This method is only effective if used as soon as possible after sexual intercourse and before ovulation. A single dose of 30 mg ulipristal acetate, a novel selective progesterone receptor modulator, has recently been proposed for the emergency contraception use up to 120 h of unprotected intercourse with similar side effect profiles as levonorgestrel. Ulipristal acetate could possibly prevent pregnancy when administered in the advanced follicular phase, even if luteinizing hormone levels have already begun to rise, a time when levonorgestrel is no longer effective in inhibiting ovulation. PMID:22629083

  15. Analysis of motivation to contraceptive use applying the weighting procedure.

    PubMed

    Chowdhury, A I; Phillips, J F

    1989-01-01

    This paper presents a technique for scaling contraceptive use motivation for the sample population of the Family Planning Health Services Project in Matlab. The project, which began in 1977, is conducted by the International Centre for Diarrhoeal Disease Research, Bangladesh. The hypothesis of the research is that through the use of a scaling algorithm the power of demographic characteristics, attitudes, and intentions for predicting contraceptive use can be enhanced. The analysis shows that two factors explain use motivation. Scale 1 is weighted for demographic variables and desire for additional children, while Scale 2 is comprised of education and intentions of contraceptive use. Both scales have a pronounced independent predictive power. We conclude that scaling has improved upon the predictive power of indicators of reproductive motivations. PMID:2629115

  16. Does the prevalence of latent toxoplasmosis and frequency of Rhesus-negative subjects correlate with the nationwide rate of traffic accidents?

    PubMed

    Flegr, Jaroslav; Dama, Madhukar

    2014-12-01

    Latent toxoplasmosis is probably the most common protistan parasitic disease with many indirect negative impacts on human health. One of the important impacts is impaired psychomotor function leading to reduced driving efficiency in Toxoplasma-seropositive subjects. Numerous case-control studies have established a positive relation between the seroprevalence of Toxoplasma gondii (Nicolle et Manceaux, 1908) and probability of traffic accidents in study populations. The prevalence of toxoplasmosis varies between populations according to local geographical conditions, hygienic practices and kitchen habits. Similarly, we see a striking variation in the incidence of traffic accidents across countries. Hence, we compiled the largest ever data set on the seroprevalence of toxoplasmosis and tried to understand its role in traffic accident-related deaths and disabilities across 87 countries. Simple non-parametric analysis showed a positive and strong relation of T. gondii seroprevalence and traffic accident related disabilities. Further, we conducted multivariate analysis to control for confounding factors. After controlling for wealth, geographical latitude, health of population, length of roads and number of vehicles, the correlation disappeared. When the frequency of RhD negativity and its interaction with toxoplasmosis were included into the model, the effects of toxoplasmosis seemingly returned. However, the analysed data suffered from the problem of multicollinearity. When a proper method of analysis, ridge regression, was applied, the effects of toxoplasmosis prevalence and RhD negativity frequency disappeared again. The existence of a strong correlation between the prevalence of toxoplasmosis and health of population in particular countries, which was the probable cause of multicollinearity and possible reason for the negative result of the present study, suggests that 'asymptomatic' latent toxoplasmosis could have a large impact on public health. PMID:25651689

  17. Gender differences in the association of individual social class and neighbourhood unemployment rate with prevalent type 2 diabetes mellitus: a cross-sectional study from the DIAB-CORE consortium

    PubMed Central

    Müller, Grit; Hartwig, Saskia; Greiser, Karin Halina; Moebus, Susanne; Pundt, Noreen; Schipf, Sabine; Völzke, Henry; Maier, Werner; Meisinger, Christa; Tamayo, Teresa; Rathmann, Wolfgang; Berger, Klaus

    2013-01-01

    Objective To analyse gender differences in the relationship of individual social class, employment status and neighbourhood unemployment rate with present type 2 diabetes mellitus (T2DM). Design Five cross-sectional studies. Setting Studies were conducted in five regions of Germany from 1997 to 2006. Participants The sample consisted of 8871 individuals residing in 226 neighbourhoods from five urban regions. Primary and secondary outcome measures Prevalent T2DM. Results We found significant multiplicative interactions between gender and the individual variables–—social class and employment status. Social class was statistically significantly associated with T2DM in men and women, whereby this association was stronger in women (lower vs higher social class: OR 2.68 (95% CIs 1.66 to 4.34)) than men (lower vs higher social class: OR 1.78 (95% CI 1.22 to 2.58)). Significant associations of employment status and T2DM were only found in women (unemployed vs employed: OR 1.73 (95% CI 1.02 to 2.92); retired vs employed: OR 1.77 (95% CI 1.10 to 2.84); others vs employed: OR 1.64 (95% CI 1.01 to 2.67)). Neighbourhood unemployment rate was associated with T2DM in men (high vs low tertile: OR 1.52 (95% CI 1.18 to 1.96)). Between-study and between-neighbourhood variations in T2DM prevalence were more pronounced in women. The considered covariates helped to explain statistically the variation in T2DM prevalence among men, but not among women. Conclusions Social class was inversely associated with T2DM in both men and women, whereby the association was more pronounced in women. Employment status only affected T2DM in women. Neighbourhood unemployment rate is an important predictor of T2DM in men, but not in women. PMID:23794596

  18. [Lipids, lipoproteins, arterial accidents and oral contraceptives].

    PubMed

    Bakir, R; Hilliquin, P

    1986-01-01

    This work reviews lipoprotein metabolism and relationships to atherosclerosis, examines the nature of arterial accidents and lipid modifications that occur with oral contraceptive (OC) use, and assesses the practical consequences for OC prescription. Cholesterol, triglycerides, and phospholipids are not soluble in aqueous milieus, and their transport in plasma is provided by macromolecules comprising a protein part and a lipid part. 5 types of these lipoproteins are distinguished by their relative richness in lipids and protein and by the nature of their proteins. The chylomicrons carry exogenous triglycerides to the peripheral tissues and cholesterol of dietary origin to the liver. Very low density lipoprotein (VLDL) cholesterol is secreted by the liver and transports triglycerides and cholesterol of endogenous origin. Low denisty lipoprotein (LDL) cholesterol originates in the degradation of VLDL cholesterol and transports cholesterol to the cells. High density lipoprotein (HDL) cholesterol is secreted by the liver and intestines or formed in the course of degradation of chylomicrons and VLDL cholesterol. Its role is to carry excess cholesterol in the peripheral tissues to the liver for elimination in the bile. Cholesterol thus follows 2 different pathways in the body: a path from the liver to the peripheral cells, whose markers are LDL and VLDL cholesterol and the plasma apoprotein B, and a path of return of excess cholesterol from the tissues and especially the arteries to the liver, marked by HDL cholesterol and the plasma apoprotein A. Only a proper balance between the 2 flows can prevent an excess of cholesterol in the arteries and the consequent constitution of atherosclerotic lesions. LDL and to a lesser extent VLDL cholesterol are strongly and positively correlated to atherogenic risk, while HDL cholesterol is negatively correlated to risk, independently of other risk factors. Arterial accidents occurring with OC use do not seem to be atheromatous in nature. A study by the Lipid Research Clinics of 2000 OC users and nonusers found that users had higher levels of total cholesterol, of triglycerides, and of LDL and VLDL cholesterol, while the elevation of HDL cholesterol was minimal. The effects of combinations of hormones in OCs depend on their composition. OCs with high or medium doses of estrogen cause an elevation in total cholesterol, triglycerides, and LDL and VLDL cholesterol. HDL cholesterol rises slightly with 19 norsteroids and declines with norgestrel. The ratio of total to HDL cholesterol is on the whole increased. OCs with low estrogen doses induce a decline inHDL cholesterol while the levels of total cholesterol and triglycerides remain unchanged. High dose progestin-only pills induce increases in LDL and decreases in HDL cholestrol. Total cholesterol tends to increases with 19 norsteroids and decline with noregestrel while triglycerides vary slightly. With smaller doses of progestin, less intense effects may be seen. The theoretic atherogenic risk determined by the levels and ratio of total and HDL cholesterol is thus increased with some hormonal combinations. OCs can be prescribed for women with normal lipid balance after a pretreatment lipid profile determination. Lipid balance should be reassessed regularly. OCs are contraindicated in cases of moderate or severe hypercholesterolemia and primary hypo HDLemia. Combined OCs may be used in cases of mild hyperlipoproteinemia in which other contraceptive methods are not possible if regular monitoring is provided. PMID:12341243

  19. Psychosocial conventionality, health orientation, and contraceptive use in adolescence.

    PubMed

    Costa, F M; Jessor, R; Fortenberry, J D; Donovan, J E

    1996-06-01

    This study examines the influence of psychosocial conventionality and health value orientation on regularity of condom use among adolescents in the US. Data were obtained from 971 ethnically and racially mixed students from a large urban school district in the Rocky Mountain Region who were followed up in the final wave of a 4-wave longitudinal study of adolescent health and development in 1992. The sample included only non-virgins and unmarried, sexually active persons, who had scores ranging from 151-217 on a regularity of contraceptive use measure. The most commonly used contraceptive method was the condom. Explanatory factors included a three-item scale of contraceptive use, three indexes of conventionality (the Independence-Achievement Value Discrepancy index and the Parent-Friends Compatibility and the Deviant Behavior scales), and 11 health measures on personality characteristics, perceived environmental factors, and behavior (Value on Health, Maternal Model for Health Behavior, and Exercise scales). Findings are given for a bivariate analysis, multivariate analyses, and a comparative analysis of bivariate and multivariate results. The general finding is that greater psychosocial and behavioral conventionality and greater health orientation were associated with more regular contraceptive use among sexually active male and female adolescents. Patterns were comparable for males and females. The relationships remained stable, after controls were introduced for sociodemographic characteristics. Conventionality was expressed as a higher value being placed on academic achievement and greater involvement in school achievement than on independence and having fewer friends with problem behaviors, such as drinking and smoking marijuana. More regular contraceptive use was related to greater health orientation, such as exercise, healthy diets, and seat belt use. The relationship between health orientation and conventionality and contraceptive use was stronger for African-Americans. PMID:8803732

  20. Maternal hormonal contraceptive use and offspring overweight or obesity

    PubMed Central

    Jensen, Elizabeth T.; Daniels, Julie L.; Stürmer, Til; Robinson, Whitney R.; Williams, Carmen J.; Moster, Dag; Juliusson, Petur B.; Vejrup, Kristine; Magnus, Per; Longnecker, Mathew P.

    2015-01-01

    Objective Experiments in animal models have shown a positive association between in utero exposure to pharmacologic sex hormones and offspring obesity. The developmental effects of such hormones on human obesity are unknown. Methods Using data from a large, prospective pregnancy cohort study (n=19,652), with linkage to a national prescription registry, we evaluated the association between use of hormonal contraceptives before and after conception (defined from dispensed prescription data and characterized by last date of use relative to conception, 12 – >4 months before (n=3,392), 4 – >1 months before (n=2,541), 1 – > 0 months before (n=2,997), and 0–12 weeks after (n=567)) in relation to offspring overweight or obesity at age 3 years. Results We observed a weak, inverse association between early pregnancy use of a combination oral contraceptive and offspring overweight or obesity at age 3 (adjusted OR: 0.75, 95% CI: 0.53, 1.08) and a positive, but imprecise, association with use of a progestin-only oral contraceptive in early pregnancy (adjusted OR: 1.26, 95% CI: 0.79, 2.02). In general, no association was observed between use of a hormonal contraceptive before conception and offspring overweight or obesity. A sensitivity analysis comparing combination oral contraceptive users in early pregnancy to other unplanned pregnancies without hormonal contraceptive use further strengthened the inverse association (adjusted OR: 0.70, 95% CI: 0.48, 1.02). Other sensitivity analyses were conducted to evaluate the robustness of the associations observed given varying assumptions. Conclusion Pharmacologic sex hormones in early pregnancy may be inversely or positively associated with offspring overweight or obesity at age 3, depending on the specific formulation used. The present study provides support for the potential for environmental sources of hormonally active agents to exert developmental effects. PMID:24984751

  1. Emergency contraception: knowledge, attitudes and practices among married Malay women staff at a public university in Malaysia.

    PubMed

    Najafi, Fatemeh; Rahman, Hejar Abdul; Hanafiah, Muhamad; Momtaz, Yadollah A; Ahmad, Zaiton

    2012-11-01

    There is a high rate of unintended pregnancies in Malaysia due to low contraceptive use. Only 30% of married women use modern contraceptive methods. Emergency contraception (EC) is used within a few days of unprotected sex to prevent pregnancy. The purpose of this study was to investigate the knowledge, attitudes, and practices regarding EC pill use among Malay women. A cross sectional study was conducted among married female staff using stratified random sampling from 15 faculties in the Universiti Putra Malaysia (UPM). Data about sociodemographic factors, reproductive health, knowledge, attitudes and practices regarding EC use were gathered using validated self-administered questionnaire. The response rate was 87%. Half the 294 subjects who participated had a low knowledge, 33.0% a moderate knowledge and 17.0% a good knowledge about the EC pill. Eighty-eight percent of respondents had a positive attitude and 12.0% a negative attitude toward EC. Eleven percent of respondents had previously used EC. Unplanned and unwanted pregnancies were reported by 35.0% and 14.0% of respondents, respectively. Most respondents lacked knowledge about the indications for using EC, its mechanism of action, when it can be used and its side effects. Our findings show a need to educate women about EC. PMID:23413716

  2. Dangerous triplet: Polycystic ovary syndrome, oral contraceptives and Kounis syndrome

    PubMed Central

    Erol, Nurdan; Karaagac, Aysu Turkmen; Kounis, Nicholas G

    2014-01-01

    Polycystic ovary syndrome is characterized by ovulatory dysfunction, androgen excess and polycystic ovaries and is associated with hypertension, diabetes, metabolic syndrome and cardiovascular events. Oral contraceptives constitute ?rst-line treatment, particularly when symptomatic hyperandrogenism is present. However, these drugs are associated with cardiovascular events and hypersensitivity reactions that pose problem in differential diagnosis and therapy. We present a 14 year-old female with polycystic ovary syndrome taking oral contraceptive and suffering from recurrent coronary ischemic attacks with increased eosinophils, and troponin levels suggesting Kounis syndrome. PMID:25548619

  3. Predicting contraceptive use in Bangladesh: a logistic regression analysis.

    PubMed

    Chowdhury, A I; Phillips, J F

    1989-04-01

    Family planning knowledge, attitude and practice surveys typically assess respondents' reproductive attitudes and intentions to use contraception. Longitudinal observation of individual respondents nevertheless shows that such questions are not strongly predictive of subsequent behaviour. This study examines 3 years' data which show that a set of such responses to questions are nevertheless substantially superior in predicting behaviour than any single indicator. Thus statistical techniques which bring into account the apparent multidimensionality of contraceptive motivation can greatly improve upon the estimation of future practice of family planning in a population. PMID:2722912

  4. From the pens to the field: real-world wildlife contraception.

    PubMed

    Turner, John W; Rutberg, Allen T

    2013-12-01

    There are only two nonlethal approaches with which to manage wildlife populations: remove excess individuals or decrease reproductive rates. In the case of wild horse management, the latter has already been shown to be a more humane and less costly approach. Contraception has been known for many years to be effective in wild horses with regard to both fertility and population alteration. Field testing under real-world management situations is a critical aspect of wildlife contraception assessment. Field testing also requires documentation to justify eventual large-scale use of fertility control in population management. Furthermore, it is likely that full support by the managing agencies and acceptance of fertility control by the public will not occur until success has been demonstrated at the population level in the field. Because the transition from laboratory and captive animal trials to the real world of field research and testing of management potential in free-ranging wildlife is both essential and difficult, we identify considerations for optimizing success in the field, especially for controlling wild horse and white-tailed deer populations. This study identified the following categories for assessment: 1) field-specific logistics and tactics (including access to and identification of horses, censuses, pregnancy testing, and behavior monitoring), 2) training of field personnel and managers (including vaccine biology, preparation and delivery, and basic field methodology), 3) essential field considerations for enabling management (including population variables, environmental variables, and modeling), and 4) pitfalls of field contraception. In this assessment, we will highlight the capability for coincident pursuit of research and management and will explore field considerations applicable to many species where fertility control has potential as a management tool. PMID:24437090

  5. Reductions in HIV prevalence rates among substance-using men who have sex with men in Los Angeles County, 2008-2011.

    PubMed

    Reback, Cathy J; Fletcher, Jesse B

    2014-10-01

    An outreach program performed street encounters with 5,599 unique substance-using MSM from January 2008 through December 2011. HIV prevalence reduced from 20.2% in the first half of 2008 to 8.1% in the second half of 2011. Older, gay-identified, non-Hispanic/Latino participants were each more likely to report a HIV-positive serostatus. When controlling for these cofactors, robust log-Poisson analysis revealed that each additional day of methamphetamine (RRR = 1.03; 95% CI [1.02, 1.03]) and/or marijuana (RRR = 1.01; 95% CI [1.01, 1.02]) use in the previous 30 days, injection drug use at any point in their lifetime (RRR = 2.01; 95% CI [1.70, 2.37]), and/or unprotected anal intercourse with another male in the previous 30 days (RRR = 1.48; 95% CI [1.29, 1.71]) were associated with HIV-positive status. When controlling for all these cofactors, the probability of reporting a HIV-positive status reduced an estimated 9% (95% CI [6%, 12%]) every six months throughout the reporting period. Self-reported HIV prevalence decreased among this sample of substance-using MSM in LAC from 2008 to 2011. PMID:25299809

  6. Avoiding Unwanted Pregnancy-The Role of Communication, Information and Knowledge in the Use of Contraception among Young Norwegian Women.

    ERIC Educational Resources Information Center

    Sundby, Johanne; Svanemyr, Joar; Maehre, Tale

    1999-01-01

    Study identified early entry points to sexuality, contraception, abortion, and post-abortion counseling. Young women (N=102) seeking an abortion or contraceptives were interviewed. Results showed there are different levels of consistency in contraceptive use among women, and that even women with few partners and fairly good contraceptive

  7. New and emerging contraceptives: a state-of-the-art review

    PubMed Central

    Bahamondes, Luis; Bahamondes, M Valeria

    2014-01-01

    Background The first hormonal contraceptive was introduced onto the market in several countries 50 years ago; however, the portfolio of contraceptive methods remains restricted with regards to their steroid composition, their cost, and their ability to satisfy the requirements of millions of women/couples in accordance with their different reproductive intentions, behaviors, cultures, and settings. Methods A literature review was conducted using Medline, Embase, and Current Contents databases, up to September 1, 2013 to identify publications reporting new contraceptives in development using combinations of the search terms: contraception, contraceptives, oral contraceptives, patch, vaginal ring, implants, intrauterine contraceptives, and emergency contraception (EC). Also, several experts in the field were also consulted to document ongoing projects on contraception development. Additionally, the Clinicaltrial.gov website was searched for ongoing studies on existing contraceptive methods and new and emerging female contraceptives developed over the past 5 years. Information was also obtained from the pharmaceutical industry. Results Early sexual debut and late menopause means that women may require contraception for up to 30 years. Although oral, injectable, vaginal, transdermal, subdermal, and intrauterine contraceptives are already available, new contraceptives have been developed in an attempt to reduce side effects and avoid early discontinuation, and to fulfill women’s different requirements. Research efforts are focused on replacing ethinyl-estradiol with natural estradiol to reduce thrombotic events. In addition, new, less androgenic progestins are being introduced and selective progesterone receptor modulators and new delivery systems are being used. In addition, research is being conducted into methods that offer dual protection (contraception and protection against human immunodeficiency virus transmission), and contraceptives for use “on demand.” Studies are also investigating non-hormonal contraceptive methods that have additional, non-contraceptive benefits. Conclusion The most pressing need worldwide is, first, that the highly effective contraceptive methods already available should be affordable to most of the population and also that these methods should fulfill the needs of women of different ages and with different reproductive requirements. The development of new contraceptive methods should also take advantage of the knowledge obtained over the past 30 years on gamete physiology and gamete interaction to avoid the use of steroid compounds. PMID:24570597

  8. Predicting contraceptive behavior among college students: the role of communication, knowledge, sexual anxiety, and self-esteem.

    PubMed

    Burger, J M; Inderbitzen, H M

    1985-08-01

    Undergraduate students were surveyed about their sexual behavior and contraceptive behavior. In addition, measures of their self-esteem, knowledge about contraception, communication with their dating partners, communication about sexual matters with their sexual partners, and sexual anxiety were taken. Consistent with Byrne's (1983) model of effective contraception, it was found that general and sexual communication with one's partner were significant predictors of contraception use. Directional, but statistically weak, support was obtained for the predictions that knowledge about contraception and sexual anxiety would be related to contraception use. No support was found for the prediction that general self-esteem would be associated with contraceptive behavior. PMID:4051721

  9. Estimating trematode prevalence in snail hosts using a single-step duplex PCR: how badly does cercarial shedding underestimate infection rates?

    PubMed Central

    2014-01-01

    Background Trematode communities often consist of different species exploiting the same host population, with two or more trematodes sometimes co-occuring in the same host. A commonly used diagnostic method to detect larval trematode infections in snails has been based on cercarial shedding, though it is often criticized as inaccurate. In the present study we compare infection prevalences determined by cercarial emission with those determined, for the first time, by molecular methods, allowing us to quantify the underestimation of single and double infections based on cercarial emission. We thus developed a duplex PCR for two host-parasite systems, to specifically differentiate between single and double infections. The Ebro samples include two morphologically similar opecoelids, whereas the Otago samples include two morphologically different larval trematodes. Methods Snails were screened for infections by incubating them individually to induce cercarial emission, thus determining infection following the “classical” detection method. Snail tissue was then removed and fixed for the duplex PCR. After obtaining ITS rDNA sequences, four species-specific primers were designed for each snail-trematode system, and duplex PCR prevalence was determined for each sample. Results from both methods were statistically compared using the McNemar’s Chi-squared test and Cohen’s Kappa Statistic for agreement between outcomes. Results Overall infection prevalences determined by duplex PCR were consistently and substantially higher than those based on cercarial shedding: among Ebro samples, between 17.9% and 60.1% more snails were found infected using the molecular method, whereas in the Otago samples, the difference was between 9.9% and 20.6%. Kappa values generally indicated a fair to substantial agreement between both detection methods, showing a lower agreement for the Ebro samples. Conclusions We demonstrate that molecular detection of single and double infections by duplex PCR strongly outcompetes the classical method. Detection failure is most likely due to immature and covert infections, however, the higher incidence of misidentified double infections in the Ebro samples arises from morphological similarity of closely-related species. The higher accuracy of the duplex PCR method also adds to our understanding of community structure of larval trematodes in snail hosts, by providing a clearer assessment of the importance of interspecific interactions within the host. PMID:24884978

  10. Types of combined oral contraceptives used by U.S. women

    PubMed Central

    Hall, Kelli Stidham; Trussell, James

    2012-01-01

    Background We sought to estimate the prevalence of types of combined oral contraceptives (COC) used among U.S. women. Study Design We analyzed interview-collected data from 12,279 women ages 15–44 years participating in the National Survey of Family Growth, 2006–2010. Analyses focused on COC use overall, by pill type, across sociodemographics and health factors. Results The prevalence of current COC use (88 different brands) was 17%. The majority of COC-users used earlier formulation COCs: ?30 mcg (67%) versus <30 mcg estrogen (33%), monophasic (67%) versus multiphasic (33%) dosages, and traditional 21/7 (88%) versus extended/other cycle regimens (12%) regimens; Norgestimate (32%) and norethindrone (20%) were the most commonly used progestins. Sociodemographic, gynecological and health risk factors were associated with type of COC use. Conclusion Further investigation of specific COC use and of the factors associated with types of pills used among U.S. women at the population level is needed. PMID:22770787

  11. Current methods and attitudes of women towards contraception in Europe and America

    PubMed Central

    2013-01-01

    Background The choice of available contraceptive methods has increased in recent years; however, recent data on women’s awareness of methods and reasons for their method choice, or reasons for changing methods, is limited. The aim of this study was to examine the use and awareness of contraceptive methods in the USA, UK, Germany, Italy and Spain. Methods Quantitative survey of heterosexual women aged 25–44 years (n=2544), with no known infertility. Questions related to knowledge and use of contraceptive methods, reasons for choice and for changing methods, and sources of advice. Results There was generally good awareness of most forms of contraception in all five countries. Awareness and current usage was greatest for the contraceptive pill (awareness >98%, usage varied from 35% [Spain] to 63% [Germany]); and male condom (awareness >95%, usage varied from 20% [Germany] to 47% [Spain]); awareness of other methods varied between countries. Doctors have the greatest influence on women’s choice of contraceptive method (>50% for all countries), and are most likely to suggest the contraceptive pill or male condom. Women’s contraceptive needs change; 4–36% of contraceptive pill users were likely to change their method within 12 months. For previous contraceptive pill users (n=377), most common reason for change was concern about side effects (from 26% [Italy] to 10% [UK]); however, awareness of many non-hormonal contraceptive methods was low. Conclusions Women aged 25–44 are aware of a wide variety of contraceptive methods, but knowledge and usage of the contraceptive pill and condoms predominates. Changing contraception method is frequent, occurring for a variety of reasons, including change in life circumstances and, for pill users, concerns about side effects. PMID:23384291

  12. Small-Molecule Inhibition of BRDT for Male Contraception

    PubMed Central

    Matzuk, Martin M.; McKeown, Michael R.; Filippakopoulos, Panagis; Li, Qinglei; Ma, Lang; Agno, Julio E.; Lemieux, Madeleine E.; Picaud, Sarah; Yu, Richard N.; Qi, Jun; Knapp, Stefan; Bradner, James E.

    2012-01-01

    Summary A pharmacologic approach to male contraception remains a longstanding challenge in medicine. Toward this objective, we explored the spermatogenic effects of a selective small-molecule inhibitor (JQ1) of the bromodomain and extraterminal (BET) subfamily of epigenetic reader proteins. Here, we report potent inhibition of the testis-specific member BRDT, which is essential for chromatin remodeling during spermatogenesis. Biochemical and crystallographic studies confirm that occupancy of the BRDT acetyl-lysine binding pocket by JQ1 prevents recognition of acetylated histone H4. Treatment of mice with JQ1 reduced seminiferous tubule area, testis size, and spermatozoa number and motility without affecting hormone levels. Although JQ1-treated males mate normally, inhibitory effects of JQ1 evident at the spermatocyte and round spermatid stages cause a complete and reversible contraceptive effect. These data establish a new contraceptive that can cross the blood:testis boundary and inhibit bromodomain activity during spermatogenesis, providing a lead compound targeting the male germ cell for contraception. PaperClip PMID:22901802

  13. Contraceptive medicalisation, fear of infertility and teenage pregnancy in Brazil

    PubMed Central

    Gonçalves, Helen; Souza, Ana D.; Tavares, Patrícia A.; Cruz, Suélen H.; Béhague, Dominique P.

    2010-01-01

    In Brazil, as in many other countries, teenage pregnancy is widely recognised as a public health problem. Buttressed by a public health science of the economics of teenage pregnancy that emphasises the postponement of parenthood as key to poverty reduction, young people's lack of appreciation for medical knowledge of contraceptives is most often credited for failed attempts to reduce teenage pregnancy. Based on a longitudinal ethnographic study conducted in Pelotas, Brazil, with young people over the course of 10 years, our study found that young women who became teenage parents did not lack medical knowledge but were, rather, highly medicalised. Not only were they intensely concerned with the ill-effects of oral contraceptives on possible future fertility, they also engaged in intricate routines of contraceptive-use as a way of testing and safeguarding their fecundity. Our analysis attends to the way these practices are shaped by the problematisation of the economics of teenage pregnancy, as well as by the gendering of cultural norms relating to the transition to adulthood. We theorise the results by considering how contraceptive medicalisation enabled some women to engage with the authority of normative society, while developing a potent off-stage critique of this authority and of what they considered to be discriminatory messages imbedded in scientific discourses on teenage pregnancy. PMID:20972914

  14. Case Studies in Emergency Contraception From Six Countries

    Microsoft Academic Search

    Anna Glasier; Evert Ketting; V. T. Palan; Lesley Browne; Susheel Kaur; Xiao Bilian; Josue Garza-Flores; L. Vasquez Estrada; Grace Delano; Grace Faoye; Charlotte Ellertson; Elizabeth Armstrong

    1996-01-01

    emergency contraceptive methods are mar- keted legally, but family planning organi- zations shy away from offering them. In China, postcoital methods have long been offered by the government family planning service. However, these meth- ods have not been separated into those ad- vocated for emergency use only and those recommended for ongoing use. Finally, in Mexico and Nigeria, aware- ness

  15. Minimum effectiveness of the levonorgestrel regimen of emergency contraception

    Microsoft Academic Search

    Elizabeth Raymond; Douglas Taylor; James Trussell; Markus J. Steiner

    2004-01-01

    The standard method for estimating the effectiveness of emergency contraceptive pills (ECPs) uses external data to calculate the proportion of expected pregnancies averted by the treatment. Because these data may not be applicable to ECP study populations, this approach could result in substantial overestimation of effectiveness. We used data from two published randomized trials of the levonorgestrel and Yuzpe ECP

  16. Emergency contraception: an anomalous position in the family planning repertoire?

    Microsoft Academic Search

    Sue Ziebland

    1999-01-01

    Emergency contraception (EC) can be used up to 72 h after sex to prevent pregnancy. Internationally there is wide variation in the availability of EC. In the USA it has only recently (1997) won approval from the FDA, while the UK and New Zealand have seen calls for over the counter availability. In recent years surveys, editorials and opinion pieces in

  17. Social work student attitudes toward contraception and the HPV vaccine.

    PubMed

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

    2012-01-01

    The purpose of the current study was to examine social work student attitudes toward the social work profession's perspective on certain aspects of reproductive health in the United States: contraception, emergency contraception, and the Human Papillomavirus (HPV) vaccine. Students at a large, public, land grant university were surveyed to determine whether their personal attitudes were in line with the National Association of Social Workers (NASW) stance on reproductive health outlined in the NASW policy statement on family planning and reproductive health. The relationship between levels of religious activity and attitudes toward these aspects of reproductive health was also examined. Results suggest that almost all of the respondents support public funding for family planning. Furthermore, almost all students indicate willingness to refer clients for general contraception. However, results related to emergency contraception indicate that 72% of students disagree that it should be available for adolescents over the counter, even with parental consent, which is inconsistent with the NASW perspective. Sixty-four percent of students report believing that the HPV vaccine is unsafe. Further, as levels of religious activity increased, acceptance of some of these aspects of reproductive health decreased. Implications for social work practice, education, and directions for future research are discussed. PMID:22489559

  18. Endometrial contraception: modulation of molecular determinants of uterine receptivity

    Microsoft Academic Search

    Chander P Puri; Rajendra R Katkam; Geetanjali Sachdeva; Vishakha Patil; Dhananjay D Manjramkar; Sanjiva D Kholkute

    2000-01-01

    Modulation of endometrial receptivity is a promising approach for fertility regulation since it allows a contraceptive to act specifically at the endometrium. This was corroborated by our previous observations that treatment with low doses of a pure progesterone antagonist (PA, antiprogestin), onapristone (ZK 98299), in bonnet monkeys inhibited fertility by selectively retarding endometrial development, without affecting the hypophyseal-hypothalamic function. In

  19. Small-molecule inhibition of BRDT for male contraception.

    PubMed

    Matzuk, Martin M; McKeown, Michael R; Filippakopoulos, Panagis; Li, Qinglei; Ma, Lang; Agno, Julio E; Lemieux, Madeleine E; Picaud, Sarah; Yu, Richard N; Qi, Jun; Knapp, Stefan; Bradner, James E

    2012-08-17

    A pharmacologic approach to male contraception remains a longstanding challenge in medicine. Toward this objective, we explored the spermatogenic effects of a selective small-molecule inhibitor (JQ1) of the bromodomain and extraterminal (BET) subfamily of epigenetic reader proteins. Here, we report potent inhibition of the testis-specific member BRDT, which is essential for chromatin remodeling during spermatogenesis. Biochemical and crystallographic studies confirm that occupancy of the BRDT acetyl-lysine binding pocket by JQ1 prevents recognition of acetylated histone H4. Treatment of mice with JQ1 reduced seminiferous tubule area, testis size, and spermatozoa number and motility without affecting hormone levels. Although JQ1-treated males mate normally, inhibitory effects of JQ1 evident at the spermatocyte and round spermatid stages cause a complete and reversible contraceptive effect. These data establish a new contraceptive that can cross the blood:testis boundary and inhibit bromodomain activity during spermatogenesis, providing a lead compound targeting the male germ cell for contraception. PMID:22901802

  20. Hormonal Contraception and Thrombotic Risk: A Multidisciplinary Approach

    PubMed Central

    Chung, Richard J.; Michelson, Alan D.; Neufeld, Ellis J.; Gordon, Catherine M.; Laufer, Marc R.; Emans, S. Jean

    2011-01-01

    Heightened publicity about hormonal contraception and thrombosis risk and the publication of new guidelines by the World Health Organization in 2009 and the Centers for Disease Control and Prevention in 2010 addressing this complex issue have led to multidisciplinary discussions on the special issues of adolescents cared for at our pediatric hospital. In this review of the literature and new guidelines, we have outlined our approach to the complex patients referred to our center. The relative risk of thrombosis on combined oral contraception is three- to fivefold, whereas the absolute risk for a healthy adolescent on this therapy is only 0.05% per year. This thrombotic risk is affected by estrogen dose, type of progestin, mechanism of delivery, and length of therapy. Oral progestin-only contraceptives and transdermal estradiol used for hormone replacement carry minimal or no thrombotic risk. Transdermal, vaginal, or intrauterine contraceptives and injectable progestins need further study. A personal history of thrombosis, persistent or inherited thrombophilia, and numerous lifestyle choices also influence thrombotic risk. In this summary of one hospital's approach to hormone therapies and thrombosis risk, we review relative-risk data and discuss the application of absolute risk to individual patient counseling. We outline our approach to challenging patients with a history of thrombosis, known thrombophilia, current anticoagulation, or family history of thrombosis or thrombophilia. Our multidisciplinary group has found that knowledge of the guidelines and individualized management plans have been particularly useful for informing discussions about hormonal and nonhormonal options across varied indications. PMID:21199853