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Sample records for contraceptive prevalence rate

  1. Contraceptive prevalence in Paraguay.

    PubMed

    Morris, L; Anderson, J E; Monteith, R S; Kriskovich, R; Schoemaker, J; Frutos, O

    1978-01-01

    Contraceptive use, source of contraception, history of abortion, current pregnancy intention, and fertility rates are evaluated for a national sample of women using data from the Paraguay Contraceptive Prevalence Survey, conducted in 1977. The survey found that 15.5 percent of all women aged 15--44 and 23.6 percent of ever-married women were using effective contraceptive methods. The urban/rural difference in contraceptive use paralleled fertility differentials: over 40 percent of ever-married women were using contraception in Greater Asuncion and other urban areas compared with 15 percent in rural areas. Overall, the data indicate that high-parity rural women have the greatest need for family planning services in Paraguay.

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

    PubMed Central

    2013-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed Central

    2013-01-01

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

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

    PubMed Central

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

    2015-01-01

    Background: Contraceptive prevalence rate (CPR) is a vital indicator used by country governments, international donors, and other stakeholders for measuring progress in family planning programs against country targets and global initiatives as well as for estimating health outcomes. Because of the need for more frequent CPR estimates than population-based surveys currently provide, alternative approaches for estimating CPRs are being explored, including using contraceptive logistics data. Methods: Using data from the Demographic and Health Surveys (DHS) in 30 countries, population data from the United States Census Bureau International Database, and logistics data from the Procurement Planning and Monitoring Report (PPMR) and the Pipeline Monitoring and Procurement Planning System (PipeLine), we developed and evaluated 3 models to generate country-level, public-sector contraceptive prevalence estimates for injectable contraceptives, oral contraceptives, and male condoms. Models included: direct estimation through existing couple-years of protection (CYP) conversion factors, bivariate linear regression, and multivariate linear regression. Model evaluation consisted of comparing the referent DHS prevalence rates for each short-acting method with the model-generated prevalence rate using multiple metrics, including mean absolute error and proportion of countries where the modeled prevalence rate for each method was within 1, 2, or 5 percentage points of the DHS referent value. Results: For the methods studied, family planning use estimates from public-sector logistics data were correlated with those from the DHS, validating the quality and accuracy of current public-sector logistics data. Logistics data for oral and injectable contraceptives were significantly associated (P<.05) with the referent DHS values for both bivariate and multivariate models. For condoms, however, that association was only significant for the bivariate model. With the exception of the CYP

  6. [Reproduction and contraception. Third National Prevalence Survey 1986].

    PubMed

    1987-09-01

    Preliminary results are presented from the Third National Contraceptive Prevalence Survey of Colombia, which took place in 1986. The sample of about 4500 households was representative on the national, urban, rural, and regional levels. The total fertility rate for 1986 was estimated at 4.9 in rural areas, 2.8 in urban areas including Bogota, and 3.2 for the country as a whole, compared to 4.4 in 1976 and 6.7 in 1969. Fertility changes in women over 30 have been particularly important in the past 10 years. The number of live births per 1000 women declined from 233 in 1971-75 to 183 in 1981-86 for women aged 20-24, from 227 to 173 for women aged 25-29, from 176 to 122 for women aged 30-34, from 131 to 79 for women aged 35-39, and from 67 to 30 for women aged 40-44. 69% of women in unions did not want more children. 30% of those aged 15-19 did not want more children and 29% did not want more for at least 2 years. 98% of Colombian women knew of some contraceptive method. 82.6% of women currently in union have used a method and 63.2% were using a method at the time of the interview. 51% used a modern method. The pill was most often used by younger women, the IUD by slightly older women, and voluntary sterilization was preferred by women over 30. Women using IUDs tended to be better educated and to live in urban areas. 24% of women in union in Bogota used IUDs in 1986. Sterilization was more prevalent in the Atlantic region and in less educated women. Contraceptive usage increased from 43% to 63% of women in union between 1976-86. 18% of Colombian women were sterilized as of 1986. PROFAMILIA clinics are the most important source of IUDs and female sterilization, while drugstores and pharmacies are the most important source for pills, vaginal spermicides, condoms, and injectables. 31% of women who stated they wanted no more children were not using any family planning method. The unsatisfied need was greater for younger women, the less educated, rural women, and those in

  7. 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

  8. [Contraceptives].

    PubMed

    Jimenez Vargas, J

    1974-01-01

    Contraceptives are defined as any means of avoiding pregnancy and not as therapy. Importance is generally placed on the mechanism of action and efficiency when selection is made. Anovulatory and postcoital contraceptives (morning-after pill) are said to be linked with abortion, as are all contraceptives since a transition from using contraceptives to having abortions has often been noted in countries allowing the latter. The author in fact ascribes a general depreciation for human life to increased use of contraceptives. Detailed explanations of the female reproductive cycle and the effects of oral contraceptives on it and on the woman in general are included. Fetal development is also traced.

  9. Contraceptive prevalence, reproductive health and our common future.

    PubMed

    Diczfalusy, E

    1991-03-01

    The 1980s will go into history as a decade of lost opportunities to increase contraceptive prevalence and improve reproductive health worldwide. As the decade closes, 500 million couples still have no access to fertility regulation, there are 30-50 million induced abortions each year, 15 million infant and child deaths (30% of all deaths worldwide), an estimated 250 million new cases of sexually transmitted diseases and 60-80 million infertile couples. One of the major problems is that many policy makers are still unimpressed with the global demographic reality. World population was less than 300 million 1991 years ago. It took some 1500 years to double this number by the time of the voyages of Columbus to America. The first billion was reached at the beginning of the last century and the second in the lifetime of the author, in 1927. Then it took less than 50 years to double this number to 4 billion by 1976. Global population is 5.3 billion today. In view of such figures, it is understandable that, historically, it was this demographic concern that in the 1960s persuaded many governments to support family planning programmes. During the subsequent decades, it was gradually recognized by developing country governments that family planning lowers infant, child and maternal mortality and morbidity and reduces the number of illegal abortions and their health hazards. Today, 52 developing country governments support family planning programmes for the demographic rationale, but 65 for the reproductive health and human rights rationale. Where do we go from here? That will mainly depend on the number of years it will take to reach replacement level of fertility (around 2.1 children per couple) worldwide. If the level is reached in 2010 (the low projection of the United Nations), global population will stabilize by the end of the 21st century at 8 billion; if it is reached in 2035 (medium projection), population will stabilize around 10 billion; however, if it is reached

  10. Contraception.

    PubMed

    Lane, C; Barnes, A B

    1981-03-01

    The number of women using contraception is increasing. There are today several methods of contraception available. Behavioral methods of contraception include coitus interruptus, not ideal for psychological reasons, the rhythm method, and the cervical mucus method; they all involve periodic sexual abstinence and need extended patient education. Barrier methods include the condom, the vaginal diaphragm, the cervical cap, and all types of spermicidal agents used locally; barrier contraception can be 97% effective when properly used. Effectiveness of the IUD is 90-99%; many women experience excessive bleeding and/or expulsion of the device. IUDs are not indicated for women with vaginal infections and must be removed if pregnancy occurrs. IUDs are indicated in multiparous, healthy women. Oral contraception is the most effective way to control fertility despite the well documented side effects. Contraceptive pills contain different doses of estrogen and progesterone, and must be prescribed only after careful medical examination. Postcoital contraception can be obtained either with ethinyl estradiol and norgestrel or with diethylstilbestrol; side effects are numerous. In 1976, sexual sterilization was the 3rd most frequent surgical procedure in the U.S. The procedure must be considered a permanent one despite the increasing number of reversal successes; psychological side effects are possible but rare. Induced abortion is used as contraception and is safest when performed during the earlier stages of pregnancy. Risk of maternal death is about the same as for delivery, or 12/100,100. Methods of abortion vary according to the length of gestation. It has been suggested that barrier methods of birth control and using abortion for failures is currently the safest approach to contraception. The choice of the best contraceptive method must be made by a doctor in accordance with the clinical history and the life style of the patient, and especially taking into consideration age

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

    PubMed Central

    Lamina, Mustafa Adelaja

    2015-01-01

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

  12. Contraception in The Netherlands: the low abortion rate explained.

    PubMed

    Ketting, E; Visser, A P

    1994-07-01

    This article gives a review of the main factors that are related to the low abortion rate in the Netherlands. Attention is payed to figures on abortion and the use of contraceptive methods since the beginning of the 1960s up to the end of the 1980s. The strong acceptance of family planning was influenced by changing values regarding sexuality and the family, the transition from an agricultural to a modern industrial society, rapid economic growth, declining influence of the churches on daily life, introduction of modern mass media and the increased general educational level. The introduction of modern contraceptives (mainly the pill and contraceptive sterilization) was stimulated by a strong voluntary family planning movement, fear for overpopulation, a positive role of GPs, and the public health insurance system. A reduction of unwanted pregnancies has been accomplished through successful strategies for the prevention of teenage pregnancy (including sex education, open discussions on sexuality in mass media, educational campaigns and low barrier services) as well as through wide acceptance of sterilization. The Dutch experience with family planning shows the following characteristics: a strong wish to reduce reliance on abortion, ongoing sexual and contraceptive education related to the actual experiences of the target groups, and low barrier family planning services.

  13. Contraception in The Netherlands: the low abortion rate explained.

    PubMed

    Ketting, E; Visser, A P

    1994-07-01

    This article gives a review of the main factors that are related to the low abortion rate in the Netherlands. Attention is payed to figures on abortion and the use of contraceptive methods since the beginning of the 1960s up to the end of the 1980s. The strong acceptance of family planning was influenced by changing values regarding sexuality and the family, the transition from an agricultural to a modern industrial society, rapid economic growth, declining influence of the churches on daily life, introduction of modern mass media and the increased general educational level. The introduction of modern contraceptives (mainly the pill and contraceptive sterilization) was stimulated by a strong voluntary family planning movement, fear for overpopulation, a positive role of GPs, and the public health insurance system. A reduction of unwanted pregnancies has been accomplished through successful strategies for the prevention of teenage pregnancy (including sex education, open discussions on sexuality in mass media, educational campaigns and low barrier services) as well as through wide acceptance of sterilization. The Dutch experience with family planning shows the following characteristics: a strong wish to reduce reliance on abortion, ongoing sexual and contraceptive education related to the actual experiences of the target groups, and low barrier family planning services. PMID:7971545

  14. Prevalence of and Barriers to Dual-Contraceptive Methods Use among Married Men and Women Living with HIV in India

    PubMed Central

    Chakrapani, Venkatesan; Kershaw, Trace; Shunmugam, Murali; Newman, Peter A.; Cornman, Deborah H.; Dubrow, Robert

    2011-01-01

    Objective. To describe the prevalence and correlates of dual-contraceptive methods use (condoms and an effective pregnancy prevention method) and barriers to their use among married persons living with HIV (PLHIV) in India. Methods. We conducted a quantitative survey (93 men, 97 women), 25 in-depth interviews, seven focus groups, and five key informant interviews. Results. Prevalence of dual- contraceptive method use increased from 5% before HIV diagnosis to 23% after diagnosis (P < 0.001). Condoms were the most common contraceptive method, with prevalence increasing from 13% before diagnosis to 92% after diagnosis (P < 0.001). Barriers to using noncondom contraceptives were lack of discussion about noncondom contraceptives by health care providers, lack of acceptability of noncondom contraceptives among PLHIV, and lack of involvement of husbands in family planning counseling. Conclusion. There is a need for interventions, including training of health care providers, to increase dual-contraceptive methods use among married PLHIV. PMID:22013377

  15. Use of long-acting reversible contraceptives to reduce the rate of teen pregnancy.

    PubMed

    Rome, Ellen

    2015-11-01

    Long-acting reversible contraceptives (LARCs) are safe for use in adolescents and do not rely on compliance or adherence for effectiveness. Continuation rates are higher and pregnancy rates are lower for adolescent users of LARCs compared with short-acting methods such as oral contraceptives. Similarly, repeat pregnancy rates are lower when LARCs are used compared with other forms of contraception. Myths and misconceptions about LARCs and other contraceptives remain a barrier to their use. Health care providers are in a unique position to provide confidential care to adolescents, and should provide education to them about the various contraceptive options, especially LARCs.

  16. Contraception: Efficacy, Risks, Continuation Rates, and Use in High-Risk Women.

    PubMed

    Batur, Pelin; Bowersox, Natalie; McNamara, Megan

    2016-08-01

    The clinical update serves as a brief review of recently published, high-impact, and potentially practice-changing journal articles summarized for our readers. Topics include menopause, sexual dysfunction, breast health, contraception, osteoporosis, and cardiovascular disease. In this clinical update, we selected recent publications relevant to the use of contraceptive methods. We highlight articles on continuation rates of long-acting reversible contraception versus nonlong-acting methods, updated risks of intrauterine devices, use of estrogen-containing contraceptives during anticoagulation for venous thromboembolic events, and the efficacy of oral and emergency contraception in women with elevated body mass index. PMID:27438879

  17. 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

  18. Low prevalence of contraceptive counseling at Srinagarind hospital, Thailand among women of reproductive age with systemic lupus erythematosus

    PubMed Central

    2013-01-01

    Objective Unplanned pregnancy in women with SLE can have grave complications both for the child and the woman. We studied the prevalence of contraceptive counseling among women of reproductive age with SLE at a university hospital in Northeast Thailand. Methods Recruited: 125 women with SLE, between 15 and 50 years, followed up at the Rheumatology Clinic. A questionnaire was administered and the results analyzed to identify the prevalence of contraceptive counseling. Results The majority of women with SLE had had their reproductive goals evaluated (76.00%, 95% CI 66–83) and received contraceptive counseling (72%). Among the SLE patients at risk for pregnancy, only one-third used effective contraception and one-fifth of those did not have any background knowledge about SLE and pregnancy. Contraceptive counseling was more frequently given to women who had had a previous pregnancy or who were already concerned about SLE as related to pregnancy. Conclusion The majority of SLE patients had at one time or other received contraceptive counseling, but some reported not grasping the gravity. The survey results presented herein suggest that a multidisciplinary team is needed to improve patient knowledge regarding SLE as it affects on pregnancy and relatedly contraceptive counseling. PMID:23577791

  19. 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.

  20. Factors that determine prevalence of use of contraceptive methods for men.

    PubMed

    Ringheim, K

    1993-01-01

    Globally, men have not shared equally with women the responsibility for fertility regulation. While family planning efforts have been directed almost exclusively toward women, the lack of male involvement may also reflect the limited options available to men. Current methods for men are either coitus-dependent, such as the condom or withdrawal, or permanent, such as vasectomy. The 20-year history of social science research on male contraceptive methods is examined here in terms of the human and method factors related to the acceptability of hypothetical methods and the prevalence of use of existing methods. New male methods, particularly if reversible, may alter men's willingness to accept or share responsibility for the control of fertility. Research opportunities in the areas of gender, decision-making, communication, health education, and service delivery will be enhanced when methods for women and men are comparable.

  1. Rapid increase in contraceptive rate: since 1981 new population control policy.

    PubMed

    1984-03-01

    In December 1981 the government of the Republic of Korea announced new population control policy measures calling for an improvement of the current family planning program management system; institution of a new social and institutional support system to inculcate the small size family norm and to eradicate the parental son preference attitude; strengthening information, education, and communication (IEC) activities; and establishment of close coordination among the government organizations relating to the population programs. As a result of the policy measures, since 1982 there has been a rapid increase in the contraceptive acceptance rate. The number of contraceptive acceptors through the government program increased from 614,100 in 1981 to 1,094,600 in 1983, a 78.3% increase. There has been a marked increase in sterilization and menstrual regulation services. The program achievement for 1983 is equivalent to about 19% of the total eligible women aged 15-44. According to the contraceptive acceptors' coupon analysis, the age of women at the time of contraceptive acceptance through the government program dropped steadily from 31.4 in 1981 to 30.2 in 1983 and their number of children declined from 2.8 to 2.5 during the same period. In line with the new population control policy, several social support measures for the small size family have been strengthened. These include: income tax exemption up to 2 children; corporation tax exemption on expenditure for family planning services to employees; inclusion of population education in the formal school curriculum; and reduction of child delivery charges for sterilization acceptors after 2nd delivery in public hospitals. The 1982 National Family Health Survey revealed that the total fertility rate declined to 2.7 and the contraceptive practice rate of women aged 15-44 increased to 58% in 1982. Yet, in recent years virtually no substantial change in the fertility level and in the contraceptive practice rate has been

  2. Emergency contraception.

    PubMed

    Grimes, David A; Raymond, Elizabeth G

    2002-08-01

    Emergency contraception is used to prevent pregnancy after a coital act not adequately protected by a regular method of contraception. In contrast to early medical abortion, emergency contraception prevents a pregnancy from starting and does not disrupt an established pregnancy. The most commonly used approaches consist of two oral doses of contraceptive steroids. The levonorgestrel-only regimen (levonorgestrel, 0.75 mg, repeated in 12 hours) appears to be more effective and better tolerated than the Yuzpe regimen (ethinyl estradiol, 100 microg, and levonorgestrel, 0.5 mg, repeated in 12 hours). In the largest randomized, controlled trial to date, levonorgestrel prevented about 85% of pregnancies that would have occurred without its use. Hormonal emergency contraception has no known medical contraindications, although it is not indicated for suspected or confirmed pregnancy. However, if hormonal emergency contraception is inadvertently taken in early pregnancy, neither the woman nor the fetus will be harmed. Nausea and vomiting associated with the Yuzpe regimen can be reduced by prophylactic use of meclizine. A strong medical and legal case exists for making hormonal emergency contraception available over the counter, as has happened in countries other than the United States. Easier access to and wider use of emergency contraception could dramatically lower the high rates of unintended pregnancy and induced abortion in the United States. PMID:12160366

  3. 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

  4. Be wary of methodology and biases in reading contraceptive failure rates.

    PubMed

    1986-08-01

    Dr. T. James Trussell of the Princeton University Office of Population Research maintains that both statistical methodology and built-in study bias can profoundly influence the contraceptive failure rates quoted in journal articles and patient package inserts. He believes that the Pearl index, 1 of the 2 currently popular methodologies, should be abandoned, indicating that a number of biases are "built into" the Pearl index. Consequently, it is difficult to interpret, and its results can vary, depending on the length of the study involved. Trussell advised clinicians to remember that "Pearl index figures are not equal to the percentage of women who will become pregnant in the 1st year of use." Instead of comparing against a standard of 100, as a percentage ranking does, the Pearl index divides the number of pregnancies by the number of women-months and multiplies that figure by 2000. Another limitation of the Pearl index is that investigators who want to push a specific contraceptive method can, consciously or not, interpret the index figures to support their position. Because woman-months make up the denominator of the equation, and it is "universally true that future rates decrease over time," the longer a study runs, says Trussell, the lower the contraceptive failure rate becomes. Trussell fa ors the life-table method of calculation for its "unambiguous interpretation" and its added use in calculating continuation rates. Yet, he warns that with any calculation method, sources of bias can still pose formidable problems in achieving accurate results. He suggests clinicians look for "the big five" when interpreting failure rate data: He suggests clinicians look for "the big five" when interpreting failure rate data: sample composition bias, especially in work comparing failure rates of 2 contraceptive methods; recall or response bias found in studies using survey or interview results; self-selection bias; misreporting; and poor model design. The original

  5. Typical-use contraceptive failure rates in 43 countries with Demographic and Health Survey data: summary of a detailed report

    PubMed Central

    Polis, Chelsea B.; Bradley, Sarah E.K.; Bankole, Akinrinola; Onda, Tsuyoshi; Croft, Trevor; Singh, Susheela

    2016-01-01

    Background While most unintended pregnancies occur because couples do not use contraception, contraceptive failure is also an important underlying cause. However, few recent studies outside of the United States have estimated contraceptive failure rates, and most such studies have been restricted to married women, to a limited number of countries and to 12-month failure rate estimates. Methods Using self-reported data from 43 countries with Demographic and Health Survey data, we estimated typical-use contraceptive failure rates for seven contraceptive methods at 12, 24 and 36 months of use. We provide a median estimate for each method across 43 countries overall, in seven subregions and in individual countries. We assess differences by various demographic and socioeconomic characteristics. Estimates are not corrected for potential errors in retrospective reporting contraceptive use or potential underreporting of abortion, which may vary by country and subgroups within countries. Results Across all included countries, reported 12-month typical-use failure rates were lowest for users of longer-acting methods such as implants (0.6 failures per 100 episodes of use), intrauterine devices (1.4) and injectables (1.7); intermediate for users of short-term resupply methods such as oral contraceptive pills (5.5) and male condoms (5.4); and highest for users of traditional methods such as withdrawal (13.4) or periodic abstinence (13.9), a group largely using calendar rhythm. Conclusions Our findings help us to highlight those methods, subregions and population groups that may be in need of particular attention for improvements in policies and programs to address higher contraceptive failure rates. PMID:27018154

  6. Contraceptive implants.

    PubMed

    McDonald-Mosley, Raegan; Burke, Anne E

    2010-03-01

    Implantable contraception has been extensively used worldwide. Implants are one of the most effective and reversible methods of contraception available. These devices may be particularly appropriate for certain populations of women, including women who cannot use estrogen-containing contraception. Implants are safe for use by women with many chronic medical problems. The newest implant, Implanon (Organon International, Oss, The Netherlands), is the only device currently available in the United States and was approved in 2006. It is registered for 3 years of pregnancy prevention. Contraceptive implants have failure rates similar to tubal ligation, and yet they are readily reversible with a return to fertility within days of removal. Moreover, these contraceptive devices can be safely placed in the immediate postpartum period, ensuring good contraceptive coverage for women who may be at risk for an unintended pregnancy. Irregular bleeding is a common side effect for all progestin-only contraceptive implants. Preinsertion counseling should address possible side effects, and treatment may be offered to women who experience prolonged or frequent bleeding.

  7. Providing Contraception to Adolescents.

    PubMed

    Raidoo, Shandhini; Kaneshiro, Bliss

    2015-12-01

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

  8. [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

  9. [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.

  10. Birth prevalence rates of skeletal dysplasias.

    PubMed

    Stoll, C; Dott, B; Roth, M P; Alembik, Y

    1989-02-01

    This study establishes the prevalence rates at birth of the skeletal dysplasias which can be diagnosed in the perinatal period or during pregnancy. Using a population-based register of congenital anomalies, a prevalence rate of 3.22 0/000 was observed. The most frequent types of skeletal dysplasia were achondroplasia and osteogenesis imperfecta (0.64 0/000, 1/15,000 births), thanatophoric dysplasia and achondrogenesis (0.28 0/000). The mutation rate for achondroplasia was higher in our material than in the other studies: 3.3 x 10(-5) per gamete per generation. Our study demonstrates that prenatal diagnosis by ultrasound is possible in some skeletal dysplasias. PMID:2785882

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

    PubMed

    McGowan, James G

    2013-09-01

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

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

    PubMed

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

    2013-01-01

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

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

    PubMed

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

    2013-01-01

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

  14. 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.

  15. Prevalence of pregnancy experiences and contraceptive knowledge among single adults in a low socio-economic suburban community in Kuala Lumpur, Malaysia

    PubMed Central

    2014-01-01

    Background This study aimed to investigate the prevalence of pregnancy experience and its association with contraceptive knowledge among single adults in a low socio-economic suburban community in Kuala Lumpur, Malaysia. Methods A cross-sectional survey was conducted in 2012 among the Kerinchi suburban community. Of the total 3,716 individuals surveyed, young single adults between 18 and 35 years old were questioned with regard to their experience with unplanned pregnancy before marriage. Contraceptive knowledge was assessed by a series of questions on identification of method types and the affectivity of condoms for the prevention of sexually transmitted diseases. Results A total of 226 female and 257 male participants completed the survey. In total, eight female (3.5%) participants reported experience with an unplanned pregnancy before marriage, and five male (1.9 %) participants had the experience of impregnating their partners. The participants had a mean total score of 3.15 (SD = 1.55) for contraceptive knowledge out of a possible maximum score of five. Female participants who had experienced an unplanned pregnancy had a significantly lower contraceptive knowledge score (2.10 ± 1.48) than who had never experienced pregnancy (3.30 ± 1.35), p<0.05. Likewise, male participants who had experienced impregnating their partners had a significantly lower contraceptive knowledge score (1.60 ± 1.50) than those who did not have such experience (3.02 ± 1.59), p<0.05. Conclusion The results showed evidence of premarital unplanned pregnancy among this suburban community. The low level of contraceptive knowledge found in this study indicates the need for educational strategies designed to improve contraceptive knowledge. PMID:25438066

  16. Transdermal delivery of contraceptives.

    PubMed

    Friend, D R

    1990-01-01

    Contraceptive agents are administered to the body through a variety of routes. Research has recently been directed at examining the transdermal route for systemic delivery of contraceptive agents, including estrogens and progestins. The transdermal route has several potential advantages over the other routes of administration: (1) improved compliance, (2) once-weekly administration, (3) delivery is easily terminated, and (4) some side effects can be alleviated based on more constant delivery rates. This article reviews the permeability of skin toward contraceptive steroids and how skin permeability is evaluated. The metabolism of contraceptive steroids is also considered. Transdermal delivery systems used to deliver contraceptives are presented, followed by a detailed discussion of several delivery systems for specific contraceptive agents such as levonorgestrel and estradiol. The potential problem of skin irritation is presented as it relates to transdermal contraceptive delivery systems, all of which will be worn chronically. PMID:2272099

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

    PubMed

    Teixeira, André L; Ramos, Plínio S; Vianna, Lauro C; Ricardo, Djalma R

    2015-11-01

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

  18. Emergency contraception

    MedlinePlus

    Morning-after pill; Postcoital contraception; Birth control - emergency; Plan B; Family planning - emergency contraception ... Emergency contraception most likely prevents pregnancy in the same way as regular birth control pills: By preventing or delaying ...

  19. 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, ...

  20. Emergency Contraception

    MedlinePlus

    f AQ FREQUENTLY ASKED QUESTIONS FAQ114 CONTRACEPTION Emergency Contraception • What is emergency contraception (EC)? • How does EC work? • What are the different types of EC? • What is the most ...

  1. Male contraception

    PubMed Central

    Mathew, Vivek; Bantwal, Ganapathi

    2012-01-01

    Contraception is an accepted route for the control of population explosion in the world. Traditionally hormonal contraceptive methods have focused on women. Male contraception by means of hormonal and non hormonal methods is an attractive alternative. Hormonal methods of contraception using testosterone have shown good results. Non hormonal reversible methods of male contraception like reversible inhibition of sperm under guidanceare very promising. In this article we have reviewed the current available options for male contraception. PMID:23226635

  2. Contraceptive failure in China.

    PubMed

    Wang, Duolao

    2002-09-01

    This study examines patterns and differentials of contraceptive failure rates by method and characteristics of users, using the Chinese Two-per-Thousand Fertility Survey data. The results show that contraceptive failure rates for modern methods including sterilization are some of the highest in the world. The first year failure rates are 4.2% for male sterilization, 0.7% for female sterilization, 10.3% for IUD, 14.5% for pill, and 19.0% for condom. There are also some differentials in contraceptive failure rates by users' sociodemographic and fertility characteristics. Contraceptive failure rate declines with women's age for all reversible methods. Rural women have higher sterilization, IUD, and condom contraceptive failure rates than urban women. Women with two or more children have a higher failure rate for sterilization methods but have lower failure rates for other methods.

  3. Forgettable contraception.

    PubMed

    Grimes, David A

    2009-12-01

    The term "forgettable contraception" has received less attention in family planning than has "long-acting reversible contraception." Defined here as a method requiring attention no more often than every 3 years, forgettable contraception includes sterilization (female or male), intrauterine devices, and implants. Five principal factors determine contraceptive effectiveness: efficacy, compliance, continuation, fecundity, and the timing of coitus. Of these, compliance and continuation dominate; the key determinants of contraceptive effectiveness are human, not pharmacological. Human nature undermines methods with high theoretical efficacy, such as oral contraceptives and injectable contraceptives. By obviating the need to think about contraception for long intervals, forgettable contraception can help overcome our human fallibility. As a result, all forgettable contraception methods provide first-tier effectiveness (contraceptives today with exclusively first-tier effectiveness is the one that can be started -- and then forgotten for years.

  4. Acceptability of contraception for men: a review.

    PubMed

    Glasier, Anna

    2010-11-01

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

  5. Prevalence rates for diabetes mellitus in Puerto Rico.

    PubMed

    Haddock, L; de Conty, I T

    1991-07-01

    The aim of this study was to analyze prevalence data for diabetes mellitus obtained from a household interview of a random sample of the general population by the Department of Health of the Commonwealth of Puerto Rico for the years 1975-1986. Details of the prevalence rate by sex and age were analyzed for the years 1981, 1984, 1985, and 1986 and for the urban and rural population in 1985. The mean prevalence rate of known cases of diabetes showed a tendency to increase from 3.1% in 1975 to 5.1% in 1986. Prevalence rates adjusted for age and sex showed an increase in the mean prevalence for 1986 compared with that of 1981. The prevalence rate was significantly higher for the rural population for the age-group 45-64 yr old and for the urban population for the age-group greater than or equal to 65 yr. The prevalence rate compares with that of Mexican Americans and Puerto Ricans in the New York City area. On the basis of the prevalence data, approximately 90% of the diabetic population is non-insulin dependent and 10% are insulin dependent. Major risk factors thought to explain the increased prevalence of non-insulin-dependent diabetes are increasing longevity of the Puerto Rican population, genetic predisposition, obesity, and changes in life-styles. In conclusion, Puerto Ricans, as other Hispanic Americans, have a higher prevalence of diabetes than the white American population.

  6. [Contraception and adolescence].

    PubMed

    Amate, P; Luton, D; Davitian, C

    2013-06-01

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

  7. Shy / silent users of contraceptives in Pakistan.

    PubMed

    Hashmi, S S

    1996-01-01

    This study examines the hypothesis that shy, silent users of contraceptives in Pakistan underreport contraceptive usage. Data were obtained from the 1984-85 and 1994-95 Contraceptive Prevalence Surveys, the 1990-91 Demographic and Health Survey, and a Punjab 1993 survey. The data were reorganized to indicate the number of women who were fecund but did not have a birth within the preceding 5 years before the surveys. 698,864 women in 1984-85 did not have children and did not report contraceptive use, or 5.9% of total respondents. If these women were added to the contraceptive prevalence rate (CPR), it would rise from 7.6% to 13.5%. The higher CPR is consistent with the observed total fertility rate of 5.95. Shy or silent users were 11.9% in 1990-91 and 11.3% in 1994-95. The revised CPRs are 23.7% and 29.1%, respectively. In 1993, a follow-up survey among non-users in Punjab province showed that CPR increased from 13% in 1990-91 to 18% in 1993. Withdrawal was the most widely used method, followed by the condom and female sterilization. The increase in CPR is attributed to more open reporting among shy or silent users. Revised CPRs that include shy or silent users were consistent with total fertility rates in all 3 nationally representative surveys. Typically shy or silent users were older by about 2.3 years than current users, but had similarly aged husbands. Shy or silent users had longer duration of marriage, greater illiteracy, and less contraceptive knowledge about methods and sources. Shy or silent women had lower children ever born rates than current users. PMID:12294611

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

    PubMed Central

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

    2012-01-01

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

  9. 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…

  10. 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.

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

    PubMed

    Lei, Z W; Wu, S C; Garceau, R J; Jiang, S; Yang, Q Z; Wang, W L; Vander Meulen, T C

    1996-06-01

    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 were frequency of medical events and reasons for termination. Study termination rates were significantly lower in the intensive structured counseling group than in the routine counseling group. At one year, the total cumulative termination rates were 11% (23/204) and 42% (92/217), respectively (p < 0.0001). The most common reasons for terminating DMPA were menstrual changes. No pregnancy, serious or unexpected medical events were reported, nor were statistically or clinically significant changes in vital signs observed. We conclude that pretreatment counseling on expected side effects increases the acceptability of DMPA.

  12. Postpartum contraception.

    PubMed

    Sober, Stephanie; Schreiber, Courtney A

    2014-12-01

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

  13. State Variations in Women’s Socioeconomic Status and Use of Modern Contraceptives in Nigeria

    PubMed Central

    Lamidi, Esther O.

    2015-01-01

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

  14. Choosing a contraceptive method: why does it matter?

    PubMed

    Robey, B

    1988-04-01

    The use of contraceptives varies widely among Asian countries. Based on the most recent survey data available, the rate varies from nearly 8/10 married women aged 15-44 in Taiwan to fewer than 1/10 in Pakistan and Nepal. Women in East Asian countries are most likely to practice contraception, followed by those in Southeast Asia, with lower contraceptive prevalence rates found in South Asia. The rates of some East Asian nations now match those of the US and other developed nations, while in most South Asian nations contraception is spreading slowly. Contraceptive methods in use vary widely by country. The leading method in the greatest number of countries is sterilization, but in most countries several methods are nearly equal in popularity. Only in India is sterilization used by a majority of those people who practice contraception. Japan is the only country in which a majority of contraceptors use condoms, and only in China do 1/2 use IUDs. The choice of a particular contraceptive method is strongly influenced by 1) methods available through family planning programs, or promoted through the use of target systems; 2) religous and cultural factors; 3) concerns about side effects and safety; 4) ease of access to particular methods; 5) the medical profession; and 6) legality--in Japan the pill is illegal. In most countries the type of contraceptive that people prefer has changed since the introduction and promotion of modern methods of contraception. In general, there has been a shift to more effective methods. An increase in female sterilization at the expense of other methods such as the IUD or pill is the most common pattern. In countries where female sterilization is unpopular, use of such modern methods as the pill, IUD, or condom has increased at the expense of traditional methods. PMID:12280899

  15. Contraceptive product advertising.

    PubMed

    Kastor, A

    1985-07-01

    In the US, all national broadcast networks refuse to accept ads for contraceptive products. About 10 years ago, the National Association of Broadcasters (NAB), a trade association, inserted a ban on contraceptive ads in its advertising code for member stations. The ban was voluntary, but all NAB stations adhered to it. When the NAB dropped its advertising code in 1982, for legal reasons unrelated to contraceptive advertising, individual networks established their own codes. These codes continued the ban on contraceptives along with bans on ads for cigarettes, X-rated movies, sex magazines, and astrology services. In recent years, a few local radio and television stations and cable networks began accepting contraceptive ads. The ads, which are tasteful and straightforward, met with little or no public disapproval. Given that the national television networks through their programming willingly expose viewers to an estimated 9230 sexual acts or references a year, it is hard to understand why they persist in refusing to air contraceptive ads or to allow any references to contraceptive use in their programming. There are some hopeful signs. A number of national organizations are now publicly urging the networks to drop their ban. These organizations include the American College of Nurse-Midwives, the American Jewish Congress, and the Society for Adolescent Medicine. The Center for Population Options recently organized a task force to promote contraceptive advertising. The task force is composed of representatives from a wide range of national organizations, including the American Public Health Association and the National Urban League. The task force developed guidelines for the production and selection of contraceptive ads. The guidelines state that ads must provide accurate and clear information on product effectiveness, present comparisons with other products fairly, advise users to read all instructions, and inform listeners if there is an effectiveness waiting

  16. The birth prevalence rates for the skeletal dysplasias.

    PubMed Central

    Orioli, I M; Castilla, E E; Barbosa-Neto, J G

    1986-01-01

    This study was undertaken to establish the prevalence rates at birth of the skeletal dysplasias that can be recognised in the perinatal period. Using the data base of the Latin-American Collaborative Study of Congenital Malformations (ECLAMC), for the years 1978 to 1983, on 349 470 births (live and stillbirths), a crude prevalence rate of 2.3/10 000 was observed. However, several indications of under-registration suggest that the real value is about twice that observed. The most frequent types of skeletal dysplasia were achondroplasia, with a prevalence rate between 0.5 and 1.5/10 000 births, the thanatophoric dysplasia/achondrogenesis group (0.2 and 0.5/10 000 births), and osteogenesis imperfecta (0.4/10 000 births). The mutation rate for autosomal dominant achondroplasia was estimated at between 1.72 and 5.57 X 10(-5) per gamete per generation. PMID:3746832

  17. The birth prevalence rates for the skeletal dysplasias.

    PubMed

    Orioli, I M; Castilla, E E; Barbosa-Neto, J G

    1986-08-01

    This study was undertaken to establish the prevalence rates at birth of the skeletal dysplasias that can be recognised in the perinatal period. Using the data base of the Latin-American Collaborative Study of Congenital Malformations (ECLAMC), for the years 1978 to 1983, on 349 470 births (live and stillbirths), a crude prevalence rate of 2.3/10 000 was observed. However, several indications of under-registration suggest that the real value is about twice that observed. The most frequent types of skeletal dysplasia were achondroplasia, with a prevalence rate between 0.5 and 1.5/10 000 births, the thanatophoric dysplasia/achondrogenesis group (0.2 and 0.5/10 000 births), and osteogenesis imperfecta (0.4/10 000 births). The mutation rate for autosomal dominant achondroplasia was estimated at between 1.72 and 5.57 X 10(-5) per gamete per generation. PMID:3746832

  18. Unmet contraceptive needs among refugees

    PubMed Central

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

    2014-01-01

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

  19. 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…

  20. Contraceptive care for the adolescent.

    PubMed

    Feldman, Elizabeth

    2006-06-01

    Despite recent improvements in rates of teen pregnancy, abortion, birth,and contraceptive use, effective contraceptive counseling for adolescents should be a high priority for the primary care provider in the office setting. Adolescent psychosocial risk screening and appropriate counseling about sexual decision-making is necessary. Contraceptive services visits include, relevant history, limited physical examination, provision of information, anticipatory guidance about sexual behaviors, and the provision of contraceptive methods. Teens should always be encouraged to use a male condom during sex to reduce STI risk. A variety of barrier and hormonal contraceptive methods are available for the adolescent population. Education about and provision of EC is effective in reducing the rate of unintended pregnancy and abortion in the United States. Contraceptive care for adolescents is a rewarding experience for primary care providers.

  1. 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…

  2. Intrauterine contraception.

    PubMed

    Whaley, Natalie S; Burke, Anne E

    2015-11-01

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

  3. Contraceptive Equity

    PubMed Central

    Temkin, Elizabeth

    2007-01-01

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

  4. Hormonal contraceptive use in Ireland: trends and co-prescribing practices.

    PubMed

    O'Mahony, Laura; Liddy, Anne-Marie; Barry, Michael; Bennett, Kathleen

    2015-12-01

    Hormonal contraceptives are highly prevalent. Currently, little is known about Irish hormonal contraceptive trends to date since the 1995 British media contraceptive controversy. The aim of this study was to examine recent trends in contraceptive use in Ireland and to determine the frequency of co-prescriptions with important interacting medications. Approximately 40% of the Irish population are prescribed 70% of total medicines under the Irish GMS scheme. Medicines were identified using the WHO Anatomical Therapeutic Chemical (ATC) classification system. Regression analysis was used to examine trends over time. Of all contraceptives dispensed in 2013, oral contraceptives were used the most (74%) and long acting reversible contraceptives (LARCs) the least (7.5%). Fourth generation combined oral contraceptives (COCs) predominated, although a slight significant decline was shown (P < 0.0001). Second and third generation COCs were significantly increasing and decreasing, respectively (P < 0.0001). Progestin-only pills were significantly increasing (P < 0.0001 across age groups). Low rates of contraceptive co-prescribing with important interacting drugs are shown. However, 93.6% of those on enzyme-inducing anti-epileptic medications were co-prescribed ineffective contraception containing <50 μg oestrogen.Irish prescribing trends of second and third generation COCs have remained consistent since 1995. The slow decline in fourth generation COC uptake follows new evidence of an increased risk of venous thromboembolism (VTE) reported in 2011. The low, but increasing, uptake of LARCs is consistent with other countries. Co-prescribing practices involving hormonal contraceptives requires continued vigilance. This study emphasizes the need to optimize co-prescribing practices involving hormonal contraceptives and anti-epileptic medications and highlights the need to address the barriers to the currently low uptake of LARC methods in Ireland. PMID:26503402

  5. Alternate scenarios for population control in Pakistan: the issue of contraceptive method mix.

    PubMed

    Ahmed, T; Ali, S M

    1992-01-01

    The authors review Pakistan's population program, with a focus on the ideal mix of contraceptive methods needed to slow population growth. "Our objective in this exercise is to estimate the extent of services required to achieve a certain level of the Contraceptive Prevalence Rate (CPR) necessary to bring fertility down to a level desired by women." Comparison is made between single- and multiple-method approaches.

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

    NASA Astrophysics Data System (ADS)

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

    2010-05-01

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

  7. Implementing personalized medicine with asymmetric information on prevalence rates.

    PubMed

    Antoñanzas, Fernando; Juárez-Castelló, Carmelo A; Rodríguez-Ibeas, Roberto

    2016-12-01

    Although personalized medicine is becoming the new paradigm to manage some diseases, the economics of personalized medicine have only focused on assessing the efficiency of specific treatments, lacking a theoretical framework analyzing the interactions between pharmaceutical firms and healthcare systems leading to the implementation of personalized treatments. We model the interaction between the hospitals and the manufacturer of a new treatment as an adverse selection problem where the firm does not have perfect information on the prevalence across hospitals of the genetic characteristics of the patients making them eligible to receive a new treatment. As a result of the model, hospitals with high prevalence rates benefit from the information asymmetry only when the standard treatment is inefficient when applied to the patients eligible to receive the new treatment. Otherwise, information asymmetry has no value. Personalized medicine may be fully or partially implemented depending on the proportion of high prevalence hospitals. PMID:27539222

  8. Long-term effects of oral contraceptives on the prevalence of diabetes in post-menopausal women: 2007-2012 KNHANES.

    PubMed

    Kim, Sung-Woo; Jeon, Jae-Han; Lee, Won-Kee; Lee, Sungwoo; Kim, Jung-Guk; Lee, In-Kyu; Park, Keun-Gyu

    2016-09-01

    There is little information on whether past use of oral contraceptives (OCs) at child-bearing age influences the incidences of diabetes and insulin resistance (IR) after menopause. This study aimed to evaluate the association of past use of OCs with the development of diabetes and IR in post-menopausal women. This cross-sectional study was based on data from the Korea National Health and Nutrition Examination Survey carried out from 2007 to 2012. Of the 50405 participants, 6554 post-menopausal women were included in the analysis. The associations of OC use with the prevalence of diabetes in post-menopausal women were examined using multivariate logistic analysis. In addition, fasting glucose and insulin levels were measured in 3338 nondiabetic post-menopausal women, and the association between IR and OCs was examined by the analysis of covariance. The prevalence of diabetes was significantly higher in post-menopausal participants who had taken OCs for more than 6 months than in those who had never taken OCs. The association remained significant after adjusting for multiple confounding factors (odd ratio 1.379; 95 % CI 1.115-1.707; P = 0.003). The duration of OC use was also positively associated with the prevalence of diabetes. Furthermore, taking OCs for more than 6 months led to a significant increase in fasting insulin levels and HOMA-IR in nondiabetic participants. Past use of OCs for more than 6 months led to a significant increase in the prevalence of diabetes in post-menopausal women, and increased IR in nondiabetic participants. These results suggested that the prolonged use of OCs at reproductive age may be an important risk factor for developing diabetes in post-menopausal women.

  9. Factors affecting the use and non use of contraception.

    PubMed

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

    1983-12-01

    Data from the 1982 Jakarta Modular Survey were used to study the factors affecting the use and nonuse of contraception. Specific study objectives were: to present some characteristics of contraceptors and noncontraceptors; to identify the major factors affecting contraceptive use; to determine the causal structure between the factors and contraceptive use; and to understand the relationship among these factors. The data collected were organized into 4 modules: socioeconomic and migration module; contraceptive prevalence and fertility module; mortality, morbidity, nutrition, and health practice module; and contraceptive continuation module. The first 3 modules were used for collecting information from all currently married women aged 15-49 years. The last module was used for collecting information from women who used some contraceptive method through the services of a family planning clinic during the 1977-82 period. Data on 2727 women were analyzed. Users and nonusers distributed differently depending on their characteristics. The characteristics selected included age, respondent's education, husband's education, working status of the respondent, age at 1st marriage, number of living children, and experience of abortion. These variables were considered to be associated with use and nonuse of contraceptives. Compared to the nonusers, the current users were slightly older in age more educated (and had husbands who were more educated), were older when 1st married, had more living children, and had more experience in abortion. Log-linear analysis was performed on 2 groups of women. Group I included all currently married women aged 15-49 years; Group II included only "high risk" women, i.e., currently married women aged 15-34 years, not pregnant, not in menopausal stage, and have had at least 1 live birth. Contraceptive use rates were lower in Group I than in Group II. Within both groups, the users rates differed significantly according to age, age at marriage, number

  10. The influence of contraception, abortion, and natural family planning on divorce rates as found in the 2006-2010 National Survey of Family Growth.

    PubMed

    Fehring, Richard J

    2015-08-01

    The purpose of this study was to determine the influence of contraception, abortion, and natural family planning (NFP) on divorce rates of US women of reproductive age. The variables of importance of religion and frequency of church attendance were also included in the analysis. The study involved 5,530 reproductive age women in the (2006-2010) National Survey of Family Growth who indicate that they were ever married. Among the women who ever used NFP only 9.6 percent were currently divorced compared with the 14.4 percent who were currently divorced among the women who never used NFP (x (2) = 5.34, P < 0.21). Odds ratio analysis indicated that ever having an abortion, sterilization, and/or methods of contraception increased the likelihood of divorce - up to two times. Frequency of church attendance decreased the risk of divorce. Although there is less divorce among NFP users the reason might be due to their religiosity. Lay summary: Providers of natural family planning (NFP) frequently mention that couples who practice NFP have fewer divorces compared to couples who use contraception. Evidence for this comment is weak. This study utilized a large data set of 5,530 reproductive age women to determine the influence that contraception, sterilization, abortion, and NFP has on divorce rates. Among the women participants who ever used NFP only 9.6 percent were currently divorced compared with the 14.4 percent who used methods of contraception, sterilization or abortion as a family planning method. Frequency of church attendance also reduced the likelihood of divorce. PMID:26912935

  11. The influence of contraception, abortion, and natural family planning on divorce rates as found in the 2006-2010 National Survey of Family Growth.

    PubMed

    Fehring, Richard J

    2015-08-01

    The purpose of this study was to determine the influence of contraception, abortion, and natural family planning (NFP) on divorce rates of US women of reproductive age. The variables of importance of religion and frequency of church attendance were also included in the analysis. The study involved 5,530 reproductive age women in the (2006-2010) National Survey of Family Growth who indicate that they were ever married. Among the women who ever used NFP only 9.6 percent were currently divorced compared with the 14.4 percent who were currently divorced among the women who never used NFP (x (2) = 5.34, P < 0.21). Odds ratio analysis indicated that ever having an abortion, sterilization, and/or methods of contraception increased the likelihood of divorce - up to two times. Frequency of church attendance decreased the risk of divorce. Although there is less divorce among NFP users the reason might be due to their religiosity. Lay summary: Providers of natural family planning (NFP) frequently mention that couples who practice NFP have fewer divorces compared to couples who use contraception. Evidence for this comment is weak. This study utilized a large data set of 5,530 reproductive age women to determine the influence that contraception, sterilization, abortion, and NFP has on divorce rates. Among the women participants who ever used NFP only 9.6 percent were currently divorced compared with the 14.4 percent who used methods of contraception, sterilization or abortion as a family planning method. Frequency of church attendance also reduced the likelihood of divorce.

  12. Contraception-21.

    PubMed

    Fathalla, M F

    1999-12-01

    A Contraception-21 strategy was adopted by the Rockefeller Foundation in 1993. The objective of the strategy is to mobilize and lift up the whole field of contraceptive research, to develop novel contraceptive approaches for the next century. The premise of the strategy is that, in spite of technological advances in the past few decades, current contraceptive choices are still inadequate to meet present and rapidly expanding future needs, particularly in developing countries. The central theme of the strategy is that it should be driven by the unmet needs of women, and not by a demographic imperative or by scientific opportunity alone. Two essential requirements are: mobilization of the science, particularly the new advances in cell and molecular biology, to provide the needed tools; and mobilization of industry to provide the needed resources.

  13. Emergency contraception with a Copper IUD or oral levonorgestrel: an observational study of 1-year pregnancy rates

    PubMed Central

    Turok, David K.; Jacobson, Janet C.; Dermish, Amna I.; Simonsen, Sara E.; Gurtcheff, Shawn; McFadden, Molly; Murphy, Patricia A.

    2014-01-01

    Objective We investigated the one-year pregnancy rates for emergency contraception (EC) users who selected the copper T380 IUD or oral levonorgestrel (LNG) for EC. Study Design This prospective study followed women for 1 year after choosing either the copper T380 IUD or oral LNG for EC. The study was powered to detect a 6% difference in pregnancy rates within the year after presenting for EC. Results Of the 542 women who presented for EC, agreed to participate in the trial, and meet inclusion criteria, 215 (40%) chose the copper IUD and 327 (60%) chose oral LNG. In the IUD group, 127 (59%) were nulligravid. IUD insertion failed in 42 women (19%). The 1-year follow-up rate was 443/542 (82%); 64% of IUD users contacted at 1 year still had their IUDs in place. The 1-year cumulative pregnancy rate in women choosing the IUD was 6.5% vs. 12.2% in those choosing oral LNG (HR= 0.53, 95% CI: 0.29–0.97, p=0.041). By type of EC method actually received, corresponding values were 5.2% for copper IUD users vs. 12.3% for oral LNG users, HR 0.42 (95% CI: 0.20–0.85, p= 0.017). A multivariable logistic regression model controlling for demographic variables demonstrates that women who chose the IUD for EC had fewer pregnancies in the following year than those who chose oral LNG (HR 0.50, 95% CI: 0.26–0.96, p=0.037). Conclusion One year after presenting for EC women choosing the copper IUD for EC were half as likely to have a pregnancy compared to those choosing oral LNG. PMID:24332433

  14. Quality of care and contraceptive use in urban Kenya

    PubMed Central

    Pence, Brian W.; Curtis, Siân L.; Marshall, Stephen W.; Speizer, Ilene S.

    2015-01-01

    CONTEXT Family planning is highly beneficial to women’s overall health, morbidity, and mortality, particularly in developing countries. Yet, in much of sub-Saharan Africa, contraceptive prevalence remains low while unmet need for family planning remains high. It has been frequently hypothesized that the poor quality of family planning service provision in many low-income settings acts as a barrier to optimal rates of contraceptive use but this association has not been rigorously tested. METHODS Using data collected from 3,990 women in 2010, this study investigates the association between family planning service quality and current modern contraceptive use in five cities in Kenya. In addition to individual-level data, audits of select facilities and service provider interviews were conducted in 260 facilities. Within 126 higher-volume clinics, exit interviews were conducted with family planning clients. Individual and facility-level data are linked based on the source of the woman’s current method or other health service. Adjusted prevalence ratios are estimated using binomial regression and we account for clustering of observations within facilities using robust standard errors. RESULTS Solicitation of client preferences, assistance with method selection, provision of information by providers on side effects, and provider treatment of clients were all associated with a significantly increased likelihood of current modern contraceptive use and effects were often stronger among younger and less educated women. CONCLUSION Efforts to strengthen contraceptive security and improve the content of contraceptive counseling and treatment of clients by providers have the potential to significantly increase contraceptive use in urban Kenya. PMID:26308259

  15. Contraceptive product advertising.

    PubMed

    Kastor, A

    1985-07-01

    In the US, all national broadcast networks refuse to accept ads for contraceptive products. About 10 years ago, the National Association of Broadcasters (NAB), a trade association, inserted a ban on contraceptive ads in its advertising code for member stations. The ban was voluntary, but all NAB stations adhered to it. When the NAB dropped its advertising code in 1982, for legal reasons unrelated to contraceptive advertising, individual networks established their own codes. These codes continued the ban on contraceptives along with bans on ads for cigarettes, X-rated movies, sex magazines, and astrology services. In recent years, a few local radio and television stations and cable networks began accepting contraceptive ads. The ads, which are tasteful and straightforward, met with little or no public disapproval. Given that the national television networks through their programming willingly expose viewers to an estimated 9230 sexual acts or references a year, it is hard to understand why they persist in refusing to air contraceptive ads or to allow any references to contraceptive use in their programming. There are some hopeful signs. A number of national organizations are now publicly urging the networks to drop their ban. These organizations include the American College of Nurse-Midwives, the American Jewish Congress, and the Society for Adolescent Medicine. The Center for Population Options recently organized a task force to promote contraceptive advertising. The task force is composed of representatives from a wide range of national organizations, including the American Public Health Association and the National Urban League. The task force developed guidelines for the production and selection of contraceptive ads. The guidelines state that ads must provide accurate and clear information on product effectiveness, present comparisons with other products fairly, advise users to read all instructions, and inform listeners if there is an effectiveness waiting

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

    PubMed

    Zeng, Yingchun; Luo, Taizhen; Zhou, Ying

    2015-09-01

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

  17. 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

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

    PubMed Central

    2014-01-01

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

  19. [Oral contraception].

    PubMed

    Guillat, J C

    1980-04-20

    OC (oral contraception) includes the combined and sequential methods, postcoital and progestin only contraception, mini pills, and macro pills. The mechanism of action of OC modifies the hypothalamo-hypophysary secretion, the uterine mucosa, and the cervical mucus. Effectiveness of OC is nearly 100%; prescription of OC requires a complete clinical and biological evaluation of the patient. Contraindications to OC are any form of cancer, hypertension, vascular or thrombotic antecedents, obesity, tabagism, diabetes. OC users must be checked at least every 6 months, and treatment can last, if there are no evident signs of side effects, until about age 40. The most commonly known side effects of OC are menstruation disorders, cardio- and cerebrovascular effects, hepatic and metabolic effects; there is no evidence that OC can cause carcinogenic effects, but it can increase teratogenic risk. The association of OC with such drugs as Rifampicine, anticonvulsants and/or tranquillizers, can nullify contraceptive effectiveness. PMID:6900393

  20. Male contraception.

    PubMed

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

    2014-08-01

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

  1. Male contraception

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  3. Intrauterine Contraception.

    PubMed

    Hsia, Jennifer K; Creinin, Mitchell D

    2016-05-01

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

  4. Advances in Male Contraception

    PubMed Central

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

    2008-01-01

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

  5. Barriers to contraceptive use among women in Benin.

    PubMed

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

    2015-01-01

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

  6. [Contraception in adolescents].

    PubMed

    1992-12-01

    The proportion of women aged 15-19 in Colombia who are mothers declined from 14% in 1985 to 10% in 1990, but the actual number of cases increased due to population growth. Some 1,780,000 adolescents who have had children or are pregnant require family planning services. An additional, unknown number of adolescent pregnancies are terminated by abortion. It is estimated that 95% of adolescent pregnancies diagnosed or followed by PROFAMILIA's center for young people were unwanted. Reasons for making family planning services available to adolescents include the ever young age at initiation of sexual activity, the very low rates of contraceptive usage among sexually active adolescents, the lack of information of adolescents concerning reproduction and contraception, and their fear and guilt surrounding their sexual activity and contraceptive usage. Obstetrical services appear reluctant to furnish adolescent mothers with information on contraception, and the pharmacists and their employees who provide such information may not be aware of contraindications for this age group or whether adolescents are adequately instructed in use of the method. The rising age at marriage increases the span of time that adolescents are at risk of unwanted pregnancy. Adolescents who are well informed about sexuality and contraception and trained in decision making, self-esteem, and responsible parenthood are likely to postpone sexual activity. Information on contraception and family planning services needs to be made available to adolescents in a way that will actually motivate use. Information on sex and contraception should be made available at puberty and should include the form of use, contraindications, and advantages and disadvantages of all methods appropriate to adolescents. Orientation and assistance in selecting the best method should be individually tailored and should be provided in schools or other places accessible to young people, in a language they can understand. Rhythm and

  7. Contraceptive development and better family planning.

    PubMed

    Segal, S J

    1996-01-01

    Contraception helps many people achieve their desired fertility. Pharmacological or mechanical contraceptive methods by themselves do not lead to successful contraception. Once empowered through education or improved socioeconomic status to realize their ability to limit their family size, women's options are abstinence (including delaying the marriage age), contraception (including surgical sterilization and natural family planning methods), or abortion. Most people in the US trying to avoid pregnancy use surgical sterilization. The reversible methods most used, in order of frequency, are the pill, the condom, and the diaphragm. The 10% of couples who use no method make up slightly more than 50% of unplanned pregnancies, while the 90% of those who use contraception make up the remaining 50% (i.e., contraceptive failures). If used properly, modern contraceptives are very effective. Methods with low failure rates (IUDs, implants, and injectables) are used by only 2% or fewer of US contraceptive users but are more widely used elsewhere. More than 50% of pregnancies in the US are unplanned. Most adolescent pregnancies are unplanned. Contraceptive users account for about 50% of induced abortions. Reducing unwanted pregnancies has helped people achieve their desired fertility and greatly reduces the induced abortion rate. The US has the highest adolescent pregnancy rate in the Western world, partly due to the time lag between initiating sexual activity and initiating contraceptive use. Reasons for unplanned pregnancies among youth include lack of counseling and contraceptive failure. Contraceptive development should focus on improving use-effectiveness. The implant is the newest contraceptive method. A variety of male and female contraceptive methods are currently under study (e.g., immunological methods, postcoital pills, skin methods [patches, creams, and gels], improved IUDs, and improved male condoms). Leaders should consider unplanned pregnancy as a serious public

  8. The Use of Long Acting Reversible Contraceptives and the Relationship between Discontinuation Rates due to Menopause and to Female and Male Sterilizations.

    PubMed

    Ferreira, Jessica Mayra; Monteiro, Ilza; Castro, Sara; Villarroel, Marina; Silveira, Carolina; Bahamondes, Luis

    2016-05-01

    Introduction Women require effective contraception until they reach menopause. The long acting reversible contraceptives (LARC) and the depot-medroxyprogesterone acetate (DMPA, Depo-Provera®, Pfizer, Puurs, Belgium) are great options and can replace possible sterilizations. Purpose To assess the relationship between the use of LARCs and DMPA and terminations ascribed to menopause and sterilizations in a Brazilian clinic. Methods We reviewed the records of women between 12 and 50 years of age attending the clinic that chose to use a LARC method or DMPA. Cumulative termination rates due to sterilization or because the woman had reached menopause were computed using single decrement life-table analysis over 32 years. We also examined all records of surgical sterilization at our hospital between the years 1980-2012. Results Three hundred thirty-two women had continuously used the same contraceptive until menopause, and 555 women had discontinued the method because they or their partners underwent sterilization. From year 20 to year 30 of use, levonorgestrel intrauterine-releasing system (LNG-IUS - Mirena®, Bayer Oy, Turku, Finland; available since 1980), copper intrauterine device (IUD - available since 1980) and DMPA users showed a trend of cumulative higher discontinuation rates due to menopause when compared with the discontinuation rates due to sterilization. Over the study period, a steep decline in the use of sterilization occurred. Conclusion Over the past 15 years of research we have observed a trend: women usually preferred to continue using LARC methods or DMPA until menopause rather than decide for sterilization, be it their own, or their partners'. The annual number of sterilizations dropped in the same period. The use of LARC methods and DMPA until menopause is an important option to avoid sterilization, which requires a surgical procedure with potential complications. PMID:27187927

  9. Emergency contraception

    PubMed Central

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

    2012-01-01

    Abstract Objective To determine the extent to which Nova Scotian FPs prescribe and provide emergency contraceptive pills (ECPs) and to explore their knowledge of and attitudes toward ECPs. Design Survey of Nova Scotian FPs using a modified Dillman method. Setting All regions of Nova Scotia. Participants Family physicians registered with Dalhousie University’s Division of Continuing Medical Education. Main outcome measures Sex differences in the provision of ECPs and knowledge and attitudes about the ECP Plan B. Results Of 913 eligible FPs, 155 (17.0%) participated in the survey. Respondents resembled the sampling frame closely. Most physicians (64.0%) had prescribed ECPs in the previous year (mean number of prescriptions, 4.92); only 12.9% provided ECPs in advance of need. Knowledge about Plan B was quite good, except for knowledge of the time frame for potential effectiveness; only 29.2% of respondents answered that question correctly. Respondents generally supported nonprescription availability of ECPs, but 25.0% of FPs were concerned that this could lead to less use of more effective methods of contraception, and 39.2% believed that it would encourage repeat use. Younger FPs provided ECPs more often than their older colleagues, while female respondents had better knowledge about Plan B. In multivariate analysis being younger than 40 years was marginally associated with prescribing Plan B and with prescribing any form of ECP. Conclusion Most Nova Scotian FPs provided ECPs and had generally good knowledge about and attitudes toward providing such contraception without prescription. However, FPs were poorly informed about the length of time that Plan B can be effective, which could potentially affect use when patients consult several days after unprotected sex. There were some concerns about nonprescription availability of ECPs, which could have implications for recommending it to patients. Rarely were ECPs prescribed for advance use, which might represent a lost

  10. Emergency Contraception.

    PubMed

    Batur, Pelin; Kransdorf, Lisa N; Casey, Petra M

    2016-06-01

    Emergency contraception (EC) may help prevent pregnancy in various circumstances, such as contraceptive method failure, unprotected sexual intercourse, or sexual assault, yet it remains underused. There are 4 approved EC options in the United States. Although ulipristal acetate requires a provider's prescription, oral levonorgestrel (LNG) is available over the counter for women of all ages. The most effective method of EC is the copper intrauterine device, which can be left in place for up to 10 years for efficacious, cost-effective, hormone-free, and convenient long-term primary contraception. Ulipristal acetate tends to be more efficacious in pregnancy prevention than is LNG, especially when taken later than 72 hours postcoitus. The mechanism of action of oral EC is delay of ovulation, and current evidence reveals that it is ineffective postovulation. Women who weigh more than 75 kg or have a body mass index greater than 25 kg/m(2) may have a higher risk of unintended pregnancy when using oral LNG EC; therefore, ulipristal acetate or copper intrauterine devices are preferable in this setting. Providers are often unaware of the range of EC options or are unsure of how to counsel patients regarding the access and use of EC. This article critically reviews current EC literature, summarizes recommendations, and provides guidance for counseling women about EC. Useful tips for health care providers are provided, with a focus on special populations, including breast-feeding women and those transitioning to long-term contraception after EC use. When treating women of reproductive age, clinicians should be prepared to counsel them about EC options, provide EC appropriately, and, if needed, refer for EC in a timely manner. PMID:27261868

  11. Contraceptive practices.

    PubMed

    Morgenthau, J E; Rao, P S

    1976-08-01

    A family life education program (FLEP) providing contraceptive services within a comprehensive health care organization for low-income, inner-city adolescents is described. Each female patient attending in the July 1-September 30, 1974, period was included in a study undertaken to identify and serve the unmet needs of the teen-age population in the community of East Harlem. Of the 334 females interviewed, almost 1/2 were black, 37% were Hispanic, 12% were white, and 2% were Oriental, totals representative of the surrounding community. The questionnaire included information on demographic and social background, sexual history, reproductive history, and contraceptive experience. Comparisons are made on the answers between groups. Personal contacts and school outreach were the 2 main sources of referral to the clinic. Sexual history was found to be associated with social background rather than physiological factors. More than 1/2 the teen-agers had never used contraception prior to their 1st clinic visit and another 1/4 of the girls were using unreliable methods. The study indicated that teen-agers will use good programs which are designed to meet their needs. For teen-agers, a free-standing clinic offering comprehensive health care is the ideal situation. PMID:1066531

  12. [Choosing contraception].

    PubMed

    Gonzalez Velez, A C

    1998-06-01

    The development of contraception has allowed women to think about and experience motherhood not as their destiny but as an option. Humans have always been interested in controlling their fertility. Writings unearthed in the 18th century demonstrated the interest of the ancient Egyptians and Greeks in fertility control. The oral contraceptive (OC) pill, developed in the 1950s by Pincus and Rock, has allowed millions of women to avoid unwanted pregnancy. Since 1960, when the oral contraceptive Enovid was first marketed in the US, over 200 million women throughout the world have used OCs. Modern formulations have low hormone doses, which has minimized side effects. OCs now have an effectiveness of 98%. The method is controlled by the woman, permitting autonomous decisions about pregnancy. Currently, in Colombia, 12.9% of women in union use OCs, 25.7% are sterilized, 11.1% each use IUDs and traditional methods, 4.3% use condoms, 2.5% use injectables, 1.4% use vaginal tablets, 0.7% each use Norplant and vasectomy, and 1.8% use other methods. 27.8% use no method. OCs can be used as an emergency method in case of rape, an unexpected sexual encounter, or failure of another method. When used as a postcoital method, OCs must be taken within 72 hours of unprotected sexual intercourse.

  13. Emergency Contraception Website

    MedlinePlus

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

  14. [Male contraception].

    PubMed

    Demoulin, A

    1984-04-01

    Among the reasons why male hormonal contraception has lagged behind female methods are the necessity of preserving virility, the fact that spermatogenesis is a continuous process, the need to control secondary effects and toxicity, and the requirement that modes of administration be acceptable to both partners. Among currently available reversible mehtods, withdrawal is undoubtedly the most ancient. It is still widespread but cannot be recommended because of its limited effectiveness. The condom is used by about 10% of couples worldwide as a principal or temporary method, but its inter-ference with sensation has limited its acceptance. Condoms are nevertheless highly effective when used with a spermicide. Various androgens are currently under investigation. High doses of testosterone can induce azoospermia without affecting libido but their side effects may be serious. The use of combinations of steroids permits doses to be reduced and offers promise for the future. The combination of oral medroxyprogesterone acetate and percutaneous testosterone is one of the better approaches; the combination is effective and nontoxic but has the disadvantage of percutaneous administration. Gossypol, a pigment extracted from the cotton plant, has been used as a contraceptive in China with a reported efficacy of 99.89%, recovery of fertility within 3 months, and no effect on future fertility. However, its toxicity appears to be significant in the animal and its reversibility is uncertain. A search is on for analogs which would preserve the contraceptive effects while eliminating toxic effects. Several gonadotropin releasing hormone (GnRH) analogs under investigation for their interference with spermatogenesis have given promising results. Several chemicals tested for contraceptive effects have had unacceptably high toxicity. Chinese investigators have reported good results with various physical methods of interfering with sperm production, but their reversibility and innocuity

  15. Contraception in the Developing World: Special Considerations.

    PubMed

    Schivone, Gillian B; Blumenthal, Paul D

    2016-05-01

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

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

    PubMed Central

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

    2015-01-01

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

  17. 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

  18. 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

  19. 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

  20. [Clinical study results with the vaginal contraceptive preparation, traceptin].

    PubMed

    Chachava, K V; Chumburidze, B I; Bakradze, M M

    1980-03-01

    This article presents the results of a clinical study which used traceptin vaginally for contraception. Traceptin is a safe and convenient application agent with a contraceptive effectiveness rate of 94%. (Authors' modified) PMID:6990808

  1. Contraceptive counseling for adolescents.

    PubMed

    Potter, Julia; Santelli, John S

    2015-11-01

    The majority of adolescents become sexually active during their teenage years, making contraceptive counseling an important aspect of routine adolescent healthcare. However, many healthcare providers express discomfort when it comes to counseling adolescents about contraceptive options. This Special Report highlights the evidence supporting age-appropriate contraceptive counseling for adolescents and focuses on best practices for addressing adolescents' questions and concerns about contraceptive methods.

  2. Comparison of Rates of and Charges from Pregnancy Complications in Users of Extended and Cyclic Combined Oral Contraceptive (COC) Regimens: A Brief Report

    PubMed Central

    Howard, Brandon; Trussell, James; Grubb, ElizaBeth; Lage, Maureen J.

    2014-01-01

    Objective Evaluate pregnancy complication rates and related charges in users of 84/7, 21/7, and 24/4 combined oral contraceptives (COCs). Study Design Data were obtained from the i3 InVision Data Mart™ retrospective claims database. Subjects were aged 15–40 years; first prescribed a COC between 1/1/2006 and 4/1/2011; and continuously insured for ≥1 year. 84/7 users were matched 1:1 to 21/7 and 24/4 users. Results Pregnancy-related complication rates and associated charges were significantly lower with 84/7 vs. 21/7 and 24/4 regimens. Conclusion Preliminary data suggest 84/7 regimens may be associated with fewer pregnancy complications and lower related charges. PMID:24457060

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

    PubMed Central

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

    2016-01-01

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

  4. Underage contraception.

    PubMed

    Southgate, L

    1985-12-01

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

  5. Rural-urban differential in contraceptive use status in Bangladesh.

    PubMed

    Uddin, M M; Kabir, M; Choudhury, S R; Ahmed, T; Bhuyan, M R

    1985-01-01

    Data from the 1981 Contraceptive Prevalence Survey (CPS) in Bangladesh were analyzed to identify and facilitate understanding of the factors responsible for urban-rural differentials in contraceptive use. The information was collected from a nationally representative sample of ever married women under 50 years. A 3-stage stratified cluster sampling design was used. A total of 196 sample areas were considered of which 116 were rural and 80 urban. The total number of households in the sample was 7393 -- 5455 rural and 1938 urban. 6269 rural and 2241 ever married eligible women were interviewed. The level of knowledge of at least 1 traditional contraceptive method was 61% for urban and 55% for rural women. The level of ever use of any specific contraceptive method was about 49% in urban and 34% in rural areas. The oral contraceptive (OC) was the most popular method of contraception in both the urban (26%) and in the rural (12.1%) areas. The popularity of other methods also varied between urban and rural residents. The higher use of some specific methods in urban areas possibly was a function of the greater avilability and accessibility of methods. The percentage of women who have ever used contraception in urban areas ranged from 27.8% at the ages of 15-19 to 59.9% at the ages of 35-39. At the ages of 40-44, the proportion of women who have ever used contraception declined by almost 14% from ages 35-39 and by as much as 20% after 44. Women in rural areas also were found to have ever used contraception at a lower rate than urban women at all age groups. In general, younger and older married women were less likely to have ever used contraception than women aged 20-39. In rural Bangladesh, more educated women and women who were employed with cash payment were more likely than other women to have ever used family planning. Women who never attended school were least likely to practice family planning (34% in urban areas and 30% in rural areas). In the urban areas more or

  6. Abortion and contraceptive practices in eastern Europe.

    PubMed

    Kovács, L

    1997-07-01

    In countries of the CCEE region (Countries of Central and Eastern Europe) the very high incidence of pregnancy termination is characteristic of family planning and the notion 'contraception instead of abortion' has not yet been achieved. The causes and consequences of this unfortunate situation will be reviewed: the reproductive health indicators in the area; the status of contraceptive use and of abortion; the impact of legislation in the different countries; and the efforts to achieve changes. The conclusions of the 'Szeged Declaration' which led to an increase in contraceptive prevalence will be discussed.

  7. 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…

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

    ERIC Educational Resources Information Center

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

    2012-01-01

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

  9. Oral Contraceptives and Cancer Risk

    MedlinePlus

    ... oral contraceptives are available in the United States today? How could oral contraceptives influence cancer risk? How ... oral contraceptives are available in the United States today? Two types of oral contraceptives (birth control pills) ...

  10. Injectable contraception.

    PubMed

    Kaunitz, A M

    1989-06-01

    The most effective, convenient, reversible method of birth control is considered to be long-acting progestogen injections. Used by over 90 countries, Depot medroxy-progesterone acetate (DMPA, Depo-Provera, Upjohn) has yet to be approved by the U.S. Food and Drug Administration. The reluctance of the FDA to approve DMPA and much of the controversy surrounding this method revolve around the results of testing done on animals who were given large doses of the progestogen over a long period of time and developed tumors. However, the large body of research and records on this method that have been compiled over the past 30 years is positive. The injectable method works like oral contraceptives, inhibiting ovulation. Changes in menstruation have been the chief complaint of women who use this method; however, the duration and frequency of spotting and bleeding diminish over time. Other side effects of DMPA and Norethindrone enanthate (NET EN, Noristerat, Schering) are discussed. Also discussed is the history of development and testing for the 2 methods and subdermal implants, specifically Norplant.

  11. 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

  12. Access to modern contraception.

    PubMed

    Welsh, Michael J; Stanback, John; Shelton, James

    2006-06-01

    Access to modern contraception has become a recognized human right, improving the health and well-being of women, families and societies worldwide. However, contraceptive access remains uneven. Irregular contraceptive supply, limited numbers of service delivery points and specific geographic, economic, informational, psychosocial and administrative barriers (including medical barriers) undermine access in many settings. Widening the range of providers enabled to offer contraception can improve contraceptive access, particularly where resources are most scarce. International efforts to remove medical barriers include the World Health Organization's Medical Eligibility Criteria. Based on the best available evidence, these criteria provide guidance for weighing the risks and benefits of contraceptive choice among women with specific clinical conditions. Clinical job aids can also improve access. More research is needed to further elucidate the pathways for expanding contraceptive access. Further progress in removing medical barriers will depend on systems for improving provider education and promoting evidence-based contraceptive service delivery. PMID:16443395

  13. Contraception for adolescents.

    PubMed

    Ott, Mary A; Sucato, Gina S

    2014-10-01

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

  14. Contraceptive revolution.

    PubMed

    Segal, S J

    1994-06-01

    Global population will increase by almost 1 billion people in the 1990s, the largest 10-year increase ever recorded. In 1994 alone, population will surpass 5.7 billion. The prospect of double-digit billions of people is worrisome, especially since these numbers may affect global warming, supplies of fresh water, destruction of rain forests, industrial pollution, and sustainable development. Yet, many indicators of quality of life show that people enjoy a better quality of life today than they did 100 years ago. Between India's independence and now, life expectancy increased by 20 years, infant mortality decreased 2-fold, literacy increased, and the food supply stabilized. Even though India's population has almost tripled since 1947, its economy increased rapidly and is 1 of the world's top 10 economies. University enrollment stands at 4.5 million. Agricultural production has exceeded demand. India represents the potential for human achievement through technological advancement and social organization. If the world's first national family planning program had been more successful when it began in 1952 in an India of 350 million people, India's population would be around 500 million instead of the expected 1 billion in 2000. All countries need to achieve a sustainable balance between human numbers and needs and natural resources. Family planning is an essential, cost-effective part of any development strategy. Family planning use has reduced fertility from 6 to 3.6 in developing countries. In 1965, only 8% used contraception, while more than 50% use it now. The most remarkable family planning/fertility reduction successes are Bangladesh, Brazil, Colombia, Indonesia, Mexico, and Thailand. Sufficient investment in family planning is needed if significant declines in fertility are to occur. More than 90% of the developing world's people are in countries with official family planning programs. Cost-effective assistance by donors and developing countries implementing

  15. Contraceptive revolution.

    PubMed

    Segal, S J

    1994-06-01

    Global population will increase by almost 1 billion people in the 1990s, the largest 10-year increase ever recorded. In 1994 alone, population will surpass 5.7 billion. The prospect of double-digit billions of people is worrisome, especially since these numbers may affect global warming, supplies of fresh water, destruction of rain forests, industrial pollution, and sustainable development. Yet, many indicators of quality of life show that people enjoy a better quality of life today than they did 100 years ago. Between India's independence and now, life expectancy increased by 20 years, infant mortality decreased 2-fold, literacy increased, and the food supply stabilized. Even though India's population has almost tripled since 1947, its economy increased rapidly and is 1 of the world's top 10 economies. University enrollment stands at 4.5 million. Agricultural production has exceeded demand. India represents the potential for human achievement through technological advancement and social organization. If the world's first national family planning program had been more successful when it began in 1952 in an India of 350 million people, India's population would be around 500 million instead of the expected 1 billion in 2000. All countries need to achieve a sustainable balance between human numbers and needs and natural resources. Family planning is an essential, cost-effective part of any development strategy. Family planning use has reduced fertility from 6 to 3.6 in developing countries. In 1965, only 8% used contraception, while more than 50% use it now. The most remarkable family planning/fertility reduction successes are Bangladesh, Brazil, Colombia, Indonesia, Mexico, and Thailand. Sufficient investment in family planning is needed if significant declines in fertility are to occur. More than 90% of the developing world's people are in countries with official family planning programs. Cost-effective assistance by donors and developing countries implementing

  16. Sterilization in Finland: from eugenics to contraception.

    PubMed

    Hemminki, E; Rasimus, A; Forssas, E

    1997-12-01

    The purpose of this paper was to describe the transition of sterilization in Finland from an eugenic tool to a contraceptive. Historical data were drawn from earlier reports in Finnish. Numbers of and reasons for sterilizations since 1950 were collected from nationwide sterilization statistics. Prevalence, characteristics of sterilized women, and women's satisfaction with sterilizations were studied from a 1994 nationwide survey (74% response rate). Logistic regression was used for adjustments. In the first half of the 20th century, eugenic ideology had influence in Finland as in other parts of Europe, and the 1935 and 1950 sterilization laws had an eugenic spirit. Regardless of this, the numbers of eugenic sterilizations remained low, and in practice, family planning was the main reason for sterilization. Nonetheless, prior to 1970 not all sterilizations were freely chosen, because sterilizations were sometimes used as a precondition for abortion. Female sterilizations showed remarkable fluctuation over time. Male sterilizations have been rare. The reasons stipulated by the law did not explain the numbers of sterilizations. In a 1994 survey, 9% of Finnish women reported they were using sterilization as their current contraceptive method (n = 189). Compared to women using other contraceptive methods, sterilized women were older, had had more births and pregnancies, and came from lower social classes. Sterilized women were satisfied with their sterilization, but there were women (8.5%) who regretted it. In conclusion, sterilizations have been and are likely to continue to be an important family planning method in Finland. The extreme gender ratio suggests a need for promoting male sterilizations, and women's expressed regrets suggest consideration of a higher age limit.

  17. [Advances in hormonal contraception].

    PubMed

    Villanueva Egan, Luis Alberto; Pichardo Cuevas, Mauricio

    2007-01-01

    This review provides an update regarding newer options in hormonal contraception that include the progestin-releasing intrauterine system, the contraceptive patch and ring, the single rod progestin-releasing implant, extended and emergency oral contraception and recent advances in hormonal male contraception. These methods represent a major advancement in this field, allowing for the development of more acceptable, safety and effective birth control regimens.

  18. Permanent contraception for women.

    PubMed

    Micks, Elizabeth A; Jensen, Jeffrey T

    2015-11-01

    Permanent methods of contraception are used by an estimated 220 million couples worldwide, and are often selected due to convenience, ease of use and lack of side effects. A variety of tubal occlusion techniques are available for female permanent contraception, and procedures can be performed using a transcervical or transabdominal approach. This article reviews currently available techniques for female permanent contraception and discusses considerations when helping patients choose a contraceptive method and tubal occlusion technique.

  19. The correlation between family planning program inputs and contraceptive use in Indonesia.

    PubMed

    Lerman, C; Molyneaux, J W; Moeljodihardjo, S; Pandjaitan, S

    1989-01-01

    Using 1980 Census and 1986 service statistics program inputs, this paper evaluates the net correlation of socioeconomic, region, and program variables with 1987 contraceptive prevalence and method-specific use rates for Indonesian regencies and municipalities. The region variables--primarily, though not exclusively, reflecting program design and maturity--correlate most strongly with the contraceptive prevalence rates. Field-worker activities, field-worker supervisor activities, and community-based distributors also have a correlation with these rates. Pill use is highest in the areas that are predominantly Islamic and least developed, whereas the pattern is reversed for use of the IUD, condom, and other modern methods (mainly female sterilization). The findings are assessed in terms of their implications for policymaking.

  20. New contraceptive methods: update 2003.

    PubMed

    Pettinato, Andrea; Emans, S Jean

    2003-08-01

    The decline in adolescent pregnancy rates noted in the 1990s has been attributed to more teenagers choosing abstinence, the availability of long-acting contraceptive options, and the increased use of condoms. Many adolescents remain at risk of unplanned pregnancy, however, because of method failure, inconsistent or incorrect use, or discontinuation of a method without choosing another method. Practitioners who care for adolescents and young women have access to several new methods in 2003. Recent additions include a contraceptive transdermal patch, a hormone-releasing intravaginal ring, new formulations of pills, and a new intrauterine device. Additionally, the World Health Organization has updated its guidelines to provide the practitioner with evidence-based recommendations to assist in selecting the most appropriate contraceptive method for each patient.

  1. Searching for Ideal Contraceptives.

    ERIC Educational Resources Information Center

    Djerassi, Carl

    1985-01-01

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

  2. Contraceptives for teenagers.

    PubMed

    Bullough, B; Bullough, V

    1991-01-01

    The contraceptive options suitable for teenagers are presented and discussed. Condoms have the advantage of preventing the spread of sexually transmitted diseases, and oral contraceptives are probably the most effective in preventing pregnancy. Other options include the barrier contraceptives available to women, spermicides, sponges, intrauterine devices, periodic abstinence, and the morning after pill.

  3. Reduction of birth prevalence rates of neural tube defects after folic acid fortification in Chile.

    PubMed

    López-Camelo, Jorge S; Orioli, Iêda M; da Graça Dutra, Maria; Nazer-Herrera, Julio; Rivera, Nelson; Ojeda, María Elena; Canessa, Aurora; Wettig, Elisabeth; Fontannaz, Ana María; Mellado, Cecília; Castilla, Eduardo E

    2005-06-01

    To verify whether the decreasing neural tube defects birth prevalence rates in Chile are due to folic acid fortification or to pre-existing decreasing trends, we performed a population survey using a network of Estudio Colaborativo Latino Americano de Malformaciones Congenitas (ECLAMC, Latin American Collaborative Study of Congenital Malformations) maternity hospitals in Chile, between the years 1982 and 2002. Within each maternity hospital, birth prevalence rates of spina bifida and anencephaly were calculated from two pre-fortification periods (1982-1989 and 1990-2000), and from one fortified period (2001-2002). There was no historical trend for spina bifida birth prevalence rates before folic acid fortification, and there was a 51% (minimum 27%, maximum 66%) decrease in the birth prevalence rates of this anomaly in the fortified period. The relative risks of spina bifida were homogeneous among hospitals in the two period comparisons. There was no historical trend for the birth prevalence of anencephaly comparing the two pre-fortified periods, but the relative risks were heterogeneous among hospitals in this comparison. There was a 42% (minimum 10%, maximum 63%) decrease in the birth prevalence rate of anencephaly in the fortified period as compared with the immediately pre-fortified period, with homogeneous relative risks among hospitals. Within the methodological constraints of this study we conclude that the birth prevalence rates for both spina bifida and anencephaly decreased as a result of folic acid fortification, without interference of decreasing secular trends.

  4. Progress with contraceptives and abortifacients.

    PubMed

    Macpherson, A

    1992-10-01

    In Canada and most other comparatively rich countries, the total fertility rate (TFR) declined from approximately 2.5 in 1970 to 1.6-1.9 in 1990. The reduction was even greater in some countries such as China, Korea, Singapore, Mauritius, Barbados, Cuba, Guadeloupe, and Puerto Rico. TFR, however, has fallen little, if at all, in many poor countries; it remains at 8.1 in Kenya and has increased from already previously high levels in Somalia, Benin, Malawi, and Rwanda. The use of contraception has been instrumental in reducing fertility. An estimated 70% of married women in rich countries use contraceptives, and a larger proportion in Eastern Asia, but only less than 15% in Africa. Education for women generally increases the level of contraceptive use. Rates, however, depend upon the degree of both acceptance and availability. An estimated 20% of births in developing countries are unwanted, so it would seem that greater availability and variety of contraceptives could lead to reductions in fertility. Research into better contraceptive technology is frustrated by paternalism, most organized religions, concern over possible future legal liability, and fear of adverse health side effects, especially in North America. Depo-Provera and RU-486, for example, have yet to be licensed in Canada for use as contraceptive agents. Research nonetheless moves forward. A vaccine against pregnancy is reportedly being developed which may be available before the turn of the century. Clinical trials have been held, and the vaccine has been found to be effective in most women, lacking in side effects, and reversible. The prototype requires a series of injections. Elsewhere, the Alza Corporation of California is working on a transdermal patch to control fertility, while some success has been reported in trials of testosterone, alone or combined with a gonadotropin-releasing hormone, to suppress sperm production in men.

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

    PubMed

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

    2015-09-23

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

  6. Contraception in women with medical problems

    PubMed Central

    Dhanjal, Mandish K

    2008-01-01

    Women with medical disease have a higher incidence of maternal mortality compared with healthy women, with cardiac disease now being the most common cause of maternal death in the UK. A handful of medical conditions exist where pregnancy is not recommended due to mortality rates approaching 50%. It is imperative that such women have the most reliable methods of contraception available. Contraceptive agents may themselves affect medical disease, or may interact with medications used by such women. There may be a range of contraceptive agents suitable for each medical condition. The contraceptive selected should be tailored to suit the individual. The following points should be considered when deciding on the most appropriate contraceptive agent: efficacy, thrombotic risk (oestrogen containing contraceptives), arterial risks (oestrogen containing contraceptives), infective risk (e.g. insertion of intrauterine device [IUD]), vagal stimulation (e.g. insertion of IUD, ESSURE®), bleeding risks with patients on anticoagulants, interaction with concomitant drugs, effects of anaesthesia and ease of use. This review aims to cover the different contraceptive agents available and the best ones to use for certain medical illnesses. PMID:27582790

  7. Contraception and Breastfeeding.

    PubMed

    Pieh Holder, Kelly Lynne

    2015-12-01

    Postpartum contraception is important to lengthening birth intervals and improving the health of women and children. For breastfeeding women the choice and timing of contraception may influence breastfeeding and infant growth patterns. Nonhormonal methods of contraception are the preferred choice for breastfeeding women. Progestin-only methods comprise a viable next option. Combined hormonal methods of contraception containing estrogen and progestin may be considered as a third option for birth control in breastfeeding women. The objective of this chapter is to review the current literature and recommendations for the use of hormonal and nonhormonal methods of contraception while breastfeeding.

  8. 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…

  9. Contraception and Diabetes.

    PubMed

    Afsana, Faria

    2016-09-01

    Contraception for women with diabetes mellitus is an important issue mainly as the pregnancy outcome depends on glycaemic control before conception among women with diabetes. Type of diabetes as type 1 or type 2 Diabetes, women with history of gestational diabetes and breast feeding diabetic mothers may be a consideration in selecting a contraceptive .On the other hand presence of diabetic complications is a significant determinant. Different methods of contraception as oral, injectable, implant, intrauterine devices are available. Patient\\'s choice and health issues both should be considered while prescribing a contraceptive to a woman with diabetes. Emergency contraception is sometimes required in situations where there is chance of contraceptive failure. This review article highlights different contraceptive methods, their use and limitations and will guide to make a rational choice for a woman with diabetes. PMID:27582166

  10. [Contraception and society].

    PubMed

    Miyahara, S

    1988-01-01

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

  11. 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.

  12. Significantly Higher Prevalence Rate of Asthma and Bipolar Disorder Co-Morbidity

    PubMed Central

    Wu, Ming-Kung; Wang, Hung-Yu; Chen, Yen-Wen; Lin, Pao-Yen; Wu, Ching-Kuan; Tseng, Ping-Tao

    2016-01-01

    Abstract Asthma and bipolar disorder (BD) are 2 distinct diseases that share similar pathophysiology. This study aimed to determine their relationship thorough a meta-analysis of articles on their comorbidity rate. The aim of the study is to examine the overall prevalence rate of BD in asthmatic patients and of asthma in BD patients compared to healthy controls. Electronic research of PubMed and ClinicalTrials.gov was performed. Articles discussing the prevalence rate of BD in patients with/without asthma and the prevalence rate of asthma in those with/without BD, as well as clinical trials in humans and case-controlled trials or cohort studies, were all included. Case reports or series and nonclinical trials were excluded. Through a random-effects model, a meta-analysis of the results of 4 studies comparing the prevalence rate of BD in patients with/without asthma, and in 6 studies comparing the prevalence rate of asthma in subjects with/without BD were performed. There were significantly higher prevalence rates of BD in asthmatic patients than in healthy controls (P < 0.001) and of asthma in BD patients than in healthy controls (P < 0.001). Only the patient's mean age significantly modulated the odds ratio of the prevalence rate of asthma in BD patients (slope = 0.015, P < 0.001). Only 10 studies were included and most were cross-sectional studies. The possible confounding effect of medication on BD or asthma onset was not investigated. Any possible etiology of the comorbidity was also not determined. This meta-analysis highlights the importance of the significantly high comorbid rate of BD and asthma, and the positive association with age. Special attention must be given to the comorbidity of asthma and BD, especially in older patients. PMID:27043688

  13. [Barrier methods of contraception].

    PubMed

    Goldsmith, A; Edelman, D A

    1982-01-01

    Vaginal methods of contraception were the earliest types used and some references to them date back to antiquity. Most of the vaginal contraceptive agents identified by the ancient Greeks, Indians, Japanese, and Chinese have been found in modern laboratory tests to have spermicidal properties, but it is doubtful that the methods were fully reliable or were used by many people. During the 19th century the condom, vaginal spermicides, and diaphragm became available. The development of nonoxynol-9 and other nonirritating but effective spermicidal agents improved vaginal contraceptives greatly by the 1950s, but starting in the 1960s newer methods began to replace the vaginal methods. Interest in barrier methods has been reawakened somewhat by concern about the health effects of hormonal methods. At present all barrier methods leave something to be desired. Failure rates of 3-30% for barrier methods in general have been estimated, but the higher rates are believed due to incorrect or inconsistent use. Theoretical failure rates of condoms and diaphragms have been estimated at 3/100 women-years, but in actual use failure rates may reach 15 for condoms and 13 for diaphragms used with spermicides. Use-effectiveness rates are greatly influenced by motivation. For a variety of reasons, the acceptability of barrier methods is low, especially in developing countries. New developments in spermicidal agents include sperm inhibitors, which impede the fertilizing capacity of sperm rather than attempting a spermicidal effect; a number of such agents have been studied and have proven more effective in animal tests than conventional spermicides. Neosampoon, a new spermicidal foam, has attracted an increasing number of users, especially in developing countries. A new condom, made of thin polymers and containing a standard dose of nonoxynol-9, has been designed to dissolve in the vaginal fluid. Further studies are needed of its acceptability, efficacy, and side effects before it becomes

  14. Barrier contraceptives and sexually transmitted diseases in women: a comparison of female-dependent methods and condoms.

    PubMed Central

    Rosenberg, M J; Davidson, A J; Chen, J H; Judson, F N; Douglas, J M

    1992-01-01

    INTRODUCTION. Most efforts at sexually transmitted disease (STD) protection center on condom use, but little is known about how condoms compare with other barrier methods, particularly those controlled by women. METHODS. To evaluate the effect of different barrier contraceptives on the prevalence of STDs and other vaginal infections, we retrospectively studied 5681 visits by women to an urban STD clinic. RESULTS. As compared with women using no contraceptive or with tubal ligations, women using the contraceptive sponge or diaphragm had at least 65% lower rates of infection with Neisseria gonorrhoeae and Trichomonas vaginalis, while condom users had 34% and 30% lower rates, respectively. For Chlamydia trachomatis, the reduction was 13% among sponge users, 72% among diaphragm users, and 3% among condom users, although these differences were not significant. When compared with women using condoms, women using female-dependent methods (sponge or diaphragm) had significantly lower rates of both gonorrhea and trichomoniasis. Vaginal candidiasis was more common among women using diaphragms but not other barrier methods, while rates of bacterial vaginosis were similar among all groups. CONCLUSIONS. Women using the contraceptive sponge or diaphragm experience protection from STDs to a greater extent than those relying on condoms. Female-dependent barrier contraceptives should receive more attention in STD risk-reduction programs. PMID:1566944

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

    PubMed

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

    1984-12-01

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

  16. Contraceptive practice in China: 1970-2004.

    PubMed

    Wang, Cuntong

    2015-03-01

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

  17. What Influences Adolescent Girls’ Decision-Making Regarding Contraceptive Methods Use and Childbearing? A Qualitative Exploratory Study in Rangpur District, Bangladesh

    PubMed Central

    Shahabuddin, A. S. M.; Nöstlinger, Christiana; Delvaux, Thérèse; Sarker, Malabika; Bardají, Azucena; Brouwere, Vincent De; Broerse, Jacqueline E. W.

    2016-01-01

    Background Bangladesh has the highest rate of adolescent pregnancy in South Asia. Child marriage is one of the leading causes of pregnancies among adolescent girls. Although the country’s contraceptive prevalence rate is quite satisfactory, only 52% of married adolescent girls use contraceptive methods. This qualitative study is aimed at exploring the factors that influence adolescent girls’ decision-making process in relation to contraceptive methods use and childbearing. Methods and Results We collected qualitative data from study participants living in Rangpur district, Bangladesh. We conducted 35 in-depth interviews with married adolescent girls, 4 key informant interviews, and one focus group discussion with community health workers. Adolescent girls showed very low decision-making autonomy towards contraceptive methods use and childbearing. Decisions were mainly made by either their husbands or mothers-in-law. When husbands were unemployed and financially dependent on their parents, then the mothers-in-law played most important role for contraceptive use and childbearing decisions. Lack of reproductive health knowledge, lack of negotiation and communication ability with husbands and family members, and mistrust towards contraceptive methods also appeared as influential factors against using contraception resulting in early childbearing among married adolescent girls. Conclusions Husbands and mothers-in-law of newly married adolescent girls need to be actively involved in health interventions so that they make more informed decisions regarding contraceptive use to delay pregnancies until 20 years of age. Misunderstanding and distrust regarding contraceptives can be diminished by engaging the wider societal actors in health intervention including neighbours, and other family members. PMID:27336673

  18. Breast-feeding: nature's contraceptive.

    PubMed

    Short, R V

    1985-01-01

    Our ancestors achieved the lowest rate of reproduction of any living mammal by the postponement of puberty until well into the 2nd decade of life, a maximal probability of conception of only about 24% per menstrual cycle even when ovulation had commenced, a 4-year birth interval as a result of the contraceptive effects of breastfeeding, and sharply declining fertility during the 4th decade of life, leading to complete sterility at the menopause. This pattern of reproduction was ideally suited to the prevailing lifestyle of the nomadic hunter-gatherer. The postponement of puberty resulted in a prolonged period of childhood dependency, thus enabling parents to transmit their acquired experience to their offspring. Long birth intervals were essential for a woman who had to wander 1000 or more miles each year in search of food, because she could not manage to carry more than 1 child with her at a time. The lifestyle of comparatively recent times of a settled agricultural economy made possible subsequent rural and urban development, but this transition from nomad to city dweller also stimulated fertility. The cultivation of crops and the domestication of animals led to the development of permanent housing, where the mother could leave her baby in a safe place while she worked in the field. The resultant reduction in mother-infant contact coupled with the availability of early weaning foods reduced the suckling frequency, thereby eroding the contraceptive effect of breastfeeding and decreasing the birth interval. The model conquest of disease eventually led to rapid rates of population growth. In the developed countries of Europe and North America, reproduction was subsequently held in check by the use of artificial forms of contraception, but this has yet to take place in the developing countries of Asia, Africa, and South America. For a developing country, contraceptives are expensive, may be culturally unacceptable, and carry health risks. Breastfeeding is 1 form of

  19. [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

  20. What's wrong with contraception?

    PubMed

    1994-01-01

    A "reader's exchange" question solicited information on how readers respond when asked what is wrong with contraception. One letter-writer maintained that the use of contraception prohibits true love, total commitment, and complete acceptance on the part of a married couple. Contraception attempts to create a utopia and obviates the pain and suffering which are necessary in order to find true love and true happiness.

  1. The current state of male hormonal contraception.

    PubMed

    Chao, Jing H; Page, Stephanie T

    2016-07-01

    World population continues to grow at an unprecedented rate, doubling in a mere 50years to surpass the 7-billion milestone in 2011. This steep population growth exerts enormous pressure on the global environment. Despite the availability of numerous contraceptive choices for women, approximately half of all pregnancies are unintended and at least half of those are unwanted. Such statistics suggest that there is still a gap in contraceptive options for couples, particularly effective reversible contraceptives for men, who have few contraceptive choices. Male hormonal contraception has been an active area of research for almost 50years. The fundamental concept involves the use of exogenous hormones to suppress endogenous production of gonadotropins, testosterone, and downstream spermatogenesis. Testosterone-alone regimens are effective in many men but high dosing requirements and sub-optimal gonadotropin suppression in 10-30% of men limit their use. A number of novel combinations of testosterone and progestins have been shown to be more efficacious but still require further refinement in delivery systems and a clearer understanding of the potential short- and long-term side effects. Recently, synthetic androgens with both androgenic and progestogenic activity have been developed. These agents have the potential to be single-agent male hormonal contraceptives. Early studies of these compounds are encouraging and there is reason for optimism that these may provide safe, reversible, and reliable contraception for men in the near future. PMID:27016468

  2. Oral Contraceptive Pill and PCOS

    MedlinePlus

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

  3. Contraception in the perimenopause.

    PubMed

    Sparrow, M

    1992-12-01

    Most clinicians advise women to continue using contraception for 12 months after menstruation has ceased. Some recommend that women less than 45 years old continue contraception for 2 years after menstruation has ceased. A fertility specialist says that women can stop taking nonhormonal methods after 6 months of amenorrhea if women experience hot flushes. If there are no classic menopausal symptoms, however, they should wait for 12 months before stopping contraception use. Hormonal methods may mask menopausal signs. If a woman has no contraindications, she can use them safely until age 50, however. Women should still use contraception after menopause because irregular ovulation may occur. In older women, the most useful measure of ovarian history is perhaps a good menstrual history rather than a high level of follicle stimulating hormone. A woman needs to consider her age, health status, menstrual history, sexuality, risk of sexually transmitted diseases, past contraception use, lifestyle, obstetric history, and attitude toward abortion when choosing a contraceptive method during the perimenopausal years. Options may include male or female sterilization, combined oral contraceptives, the progestogen-only pill, Depo-Provera, IUD, female barrier methods (diaphragm, cervical cap, contraceptive sponge, and female condom), condoms, spermicides, and postcoital contraception. Assuming the mucus signs can be reliably determined, natural family planning is an alternative for some older women. Depending on coitus interruptus can be stressful for older women because it is not easy to distinguish between a possible pregnancy and an irregular menses.

  4. Hormonal contraception. Current status and future perspectives.

    PubMed

    Holinka, C F

    1994-09-30

    Hormonal contraception was pioneered by Gregory Pincus in the 1950s. Today, hormonal contraception is accepted as having a highly favorable benefit/risk profile. There is, however, a need for the development of new contraceptive methods to broaden the range of choices and enhance motivation and compliance in users. With the staggering rate of increase in the world's population, the number of contraceptive users in developing countries is expected to increase from 381 million in 1990 to 567 million in the year 2000. This will require substantial supplies of inexpensive contraceptives and the development of new and improved methods. The use of contraceptives is an asset to women's health, which can be jeopardized by the risks of pregnancy, as well as to the psychological and social well-being of mother and child. Oral contraceptives also have noncontraceptive health benefits such as protecting against endometrial cancer, uterine fibroids, menorrhagia, benign breast disease, anemia, ovarian cancer, functional ovarian cysts, dysmenorrhea, ectopic pregnancy, salpingitis, and bone loss. The new low-dose formulations are considered to be very safe for most healthy, nonsmoking women of reproductive age. Therefore, current research efforts are focused on new delivery methods, such as vaginal rings, rather than on the development of new hormonally active steroids. Nonoral contraceptive methods which avoid first-pass effects on the liver are being developed or improved. These include implants, vaginal rings, vaginally applied pills, and progestogen-containing IUDs. Contraceptive research is also focusing on immunologic interference with the hypothalamic-pituitary-gonadal axis in both men and women. This may spawn as yet unforseen methods of molecular modulation of sperm-ovum interactions which would result in the inhibition of implantation.

  5. Oral contraceptive use among female elite athletes and age-matched controls and its relation to low back pain.

    PubMed

    Brynhildsen, J; Lennartsson, H; Klemetz, M; Dahlquist, P; Hedin, B; Hammar, M

    1997-10-01

    Exogenous and endogenous female sex steroids may influence the risk of low back pain. The fact that back pain is a very common symptom during pregnancy supports this theory. Back pain is also more common among female than male athletes. Oral contraceptives have been suggested to increase the risk of low back pain. The aim of this study was to evaluate whether the prevalence of low back pain is higher among oral contraceptive users than non-users and if it differs between women taking part in different sports. A questionnaire was sent to female elite athletes in volleyball (n = 205), basketball (n = 150), and soccer (n = 361) as well as to age-matched controls (n = 113). The questionnaire comprised questions about age, constitution, occupation, parity, and use of contraceptive method as well as previous and current back pain and possible consequences of the back problems. The response rate was 85%. Between 42% and 52% of the women in the different groups used oral contraceptives. The groups were similar in most background variables, except that the volleyball and basketball players were taller. The prevalence of current low back pain was between 21% and 34% in the different athlete groups, with an average of 30%, whereas only 18% of the controls suffered from low back pain (p 0.01). The prevalence of low back pain within each group--athletes as well as controls--was similar in women who used and did not use oral contraceptives. This study does not support the theory that low back pain is affected by the use of oral contraceptives. Instead, constitutional factors and mechanical stress during intense physical activity are probably more important.

  6. Male Adolescent Contraceptive Utilization.

    ERIC Educational Resources Information Center

    Finkel, Madelon Lubin; Finkel, David J.

    1978-01-01

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

  7. Social marketing of contraceptives.

    PubMed

    Schellstede, W P; Derr, B B

    1986-12-01

    Application of commercial marketing techniques has not only increased awareness, acceptability, and use of modern contraceptives in developing countries, but also overcome logistic problems in service delivery. The ability of contraceptive social marketing to reach large numbers and to treat contraceptives as common consumer products has helped to diminish social and religious constraints associated with family planning. Each contraceptive social marketing program is built around a theme tailored to meet specific cultural, social, and management requirements. The primary target populations are those who cannot afford regular commercial products and those who are not adequately reached by government programs. In countries such as Sri Lanka and Jamaica, profit is not a primary sales objective and retail prices are highly subsidized to make products affordable to low-income people. In contrast, the Colombian and Thai programs use contraceptive social marketing to help offset the operating costs of rural community-based programs and seek profits. The most impressive contraceptive social marketing sales performances have been recorded in Bangladesh, Colombia, Egypt, and Jamaica. The main reason contraceptive social marketing is more cost-efficient than other modes of contraceptive distribution is that the cost of product delivery is assumed by the commercial system. Although there has been some interest in making these programs self-sufficient financially, this step has tended to undermine the purpose of serving lower income groups. PMID:12341233

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

    PubMed

    Mulligan, Karen

    2015-08-01

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

  9. [Community marketing of contraceptives].

    PubMed

    Urrutia, J M

    1987-09-01

    The 5-year-old community contraceptive distribution program developed by PROFAMILIA, Colombia's private family planning organization, has given excellent results, but several cost-effectiveness comparisons with social marketing programs have suggested that commercial distribution programs are superior. The community contraceptive distribution program has a high content of information and education activities, which produced significant increases in knowledge and use of contraception in the communities covered. It has been a fundamental support for the social marketing program, creating much of the demand for contraceptive products that the social marketing program has filled. The social marketing program has given good results in terms of volume of sales and in cost-effectiveness since 1976, prompting calls for replacement of the community contraceptive distribution program by the social marketing program in those sectors where knowledge and use of contraception have achieved acceptable levels. An experiment in the Department of Santander in 1984 and 1985 gave very favorable results, suggesting that community contraceptive distribution programs should be replaced by social marketing programs in all more developed markets. But economic problems in 1985 and the decision of manufacturers to decrease the profit margin for PROFAMILIA jeopardized the social marketing program. The community distribution program covered about 20% of the market. Reduced profits in the social marketing program threatened its continued expansion, at the same time that potential demand was growing because of increases in the fertile aged population and increased use of contraception. To meet the need, PROFAMILIA combined the community contraceptive distribution and social marketing programs into a new entity to be called community marketing. The strategy of the community marketing program will be to maintain PROFAMILIA's participation in the market and aid the growth of demand for

  10. Contraceptive Practices Among Female Cancer Survivors of Reproductive Age

    PubMed Central

    Dominick, Sally A.; McLean, Mamie R.; Whitcomb, Brian W.; Gorman, Jessica R.; Mersereau, Jennifer E.; Bouknight, Janet M.; Su, H. Irene

    2015-01-01

    Objective To compare rates of contraception between reproductive-aged cancer survivors and women in the general U.S. population. Among survivors, the study examined factors associated with use of contraception and emergency contraception. Methods This study analyzed enrollment data from an ongoing national prospective cohort study on reproductive health after cancer entitled the Fertility Information Research Study. We compared current contraceptive use in survivors with that of the general population ascertained by the 2006–2010 National Survey for Family Growth. Log-binomial regression models estimated relative risks for characteristics associated with use of contraception, World Health Organization tiers I–II (sterilization and hormonal) contraceptive methods, and emergency contraception in survivors. Results Data from 295 survivors (mean age 31.6 ± 5.7 years, range 20–44 years) enrolled in this prospective study (85% response rate) were examined. Age-adjusted rates of using tiers I–II contraceptive methods were lower in survivors than the general population (34% [28.8–40.0] compared with 53% [51.5–54.5], P<.01). Only 56% of survivors reported receiving family planning services (counseling, prescription or procedure related to birth control) since cancer diagnosis. In adjusted analysis, receipt of family planning services was associated with both increased use of tiers I–II contraceptive methods (relative risk 1.3, 95% confidence interval [CI] 1.1–1.5) and accessing emergency contraception (relative risk 5.0, 95% CI 1.6–16.3) in survivors. Conclusion Lower rates of using Tiers I–II contraceptive methods were found in reproductive-aged cancer survivors compared to the general population of U.S. women. Exposure to family planning services across the cancer care continuum may improve contraception utilization among these women. Clinical Trial Registration ClinicalTrials.gov, www.clinicaltrials.gov, NCT01843140. PMID:26181090

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

    PubMed Central

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

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

    2013-01-01

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

  13. Review of newer contraceptive agents.

    PubMed

    Qureshi, M; Attaran, M

    1999-06-01

    Advances in contraceptive technology have made birth control more effective, convenient, and safe. We review the newer products and some under development, including the latest oral contraceptives, injectable progesterone, subdermal progestin implants, progesterone-releasing IUDs, emergency contraception, and male contraception.

  14. 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

  15. The 1998 Canadian Contraception Study.

    ERIC Educational Resources Information Center

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

    1999-01-01

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

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

    PubMed Central

    Adeloye, Davies; Basquill, Catriona

    2014-01-01

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

  17. Evidence based contraceptive choices.

    PubMed

    Scott, Alison; Glasier, Anna

    2006-10-01

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

  18. Contraception and headache.

    PubMed

    MacGregor, E Anne

    2013-02-01

    Most women have used at least 1 method of contraception during their reproductive years, with the majority favoring combined oral contraceptives. Women are often concerned about the safety of their method of choice and also ask about likely effects on their pre-existing headache or migraine and restrictions on using their headache medication. While there should be no restriction to the use of combined hormonal contraceptives by women with migraine without aura, the balance of risks vs benefits for women with aura are debatable. Migraine with aura, but not migraine without aura, is associated with a twofold increased risk of ischemic stroke, although the absolute risk is very low in healthy, nonsmoking women. Although ethinylestradiol has been associated with increased risk of ischemic stroke, the risk is dose-dependent. Low-dose pills currently used are considerably safer than pills containing higher doses of ethinylestradiol but they are not risk-free. This review examines the evidence available regarding the effect that different methods of contraception have on headache and migraine and identifies strategies available to minimize risk and to manage specific triggers such as estrogen "withdrawal" headache and migraine associated with combined hormonal contraceptives. The independent risks of ischemic stroke associated with migraine and with hormonal contraceptives are reviewed, and guidelines for use of contraception by women with migraine are discussed in light of the current evidence. PMID:23432442

  19. What's wrong with contraception?

    PubMed

    Rice, L; Rice, B

    1994-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  1. [Contraception in the future].

    PubMed

    Hamzaoui, R; Boukhris, M

    1994-02-01

    In the last decade, global use of contraceptive methods has increased. About 50% of couples of childbearing age use a modern contraceptive method. This evolution and a positive change in attitude towards male contraception has encouraged research in fertility regulation to enlarge and to improve acceptance of the contraceptive mix. Current injectable contraceptives interfere with the menstrual cycle. Research is exploring ways to minimize such secondary effects by reducing the total hormone dose and by changing the way the active product is delivered (e.g., microspheres). An injectable prototype is an analogue of levonorgestrel (HRP 002). A new IUD is made of leather suspended by a nylon suture which has been inserted into the uterine muscle. RU-486, often used to interrupt early pregnancy, is being tested as an oral contraceptive (OC). It inhibits secretion of gonadotropins and ovulation. It holds promise as an OC with no estrogen component. Since it also inhibits endometrial development and thus prevents implantation, it may someday be used for emergency contraception (i.e., postcoital contraception). New contraceptive implants under study include Norplant RII (2 rods of levonorgestrel lasting for 3 years), Implanon (desogestrel), and Capranor (biodegradable implant lasting 2 years). The female condom consists of a flexible polyurethane sheath with a flexible ring at each end. It has the potential to protect against sexually transmitted diseases since it covers the labial lips and is impermeable to HIV. France and Switzerland have both approved its use. It will enter the UK market at the end of the year. Approval for marketing has been sought in the US.

  2. Male hormonal contraception.

    PubMed

    Nieschlag, E

    2010-01-01

    The principle of hormonal male contraception based on suppression of gonadotropins and spermatogenesis has been established over the last three decades. All hormonal male contraceptives use testosterone, but only in East Asian men can testosterone alone suppress spermatogenesis to a level compatible with contraceptive protection. In Caucasians, additional agents are required of which progestins are favored. Current clinical trials concentrate on testosterone combined with norethisterone, desogestrel, etonogestrel, DMPA, or nestorone. The first randomized, placebo-controlled clinical trial performed by the pharmaceutical industry demonstrated the effectiveness of a combination of testosterone undecanoate and etonogestrel in suppressing spermatogenesis in volunteers. PMID:20839093

  3. The influence of gender attitudes on contraceptive use in Tanzania: new evidence using husbands' and wives' survey data.

    PubMed

    Nanda, Geeta; Schuler, Sidney Ruth; Lenzi, Rachel

    2013-05-01

    This paper explores the hypothesis that gender attitude scales (which measure the degree of equity in gender attitudes) are associated with contraceptive use. Four hundred male and female respondents (200 couples) were interviewed using a pre-tested, structured questionnaire. Analyses included comparisons of means and prevalence rates on gender equity indicators, other related factors and socio-demographic characteristics; t-tests to compare mean scores on each gender scale for wives and husbands to identify any significant differences; chi-squared tests to compare associations between individual attributes, attitudes and contraceptive use; and multivariate logistic regression to examine associations between each gender scale and contraceptive use. The findings revealed that, on average, wives endorsed more inequitable gender attitudes compared with husbands on all gender attitude scales. For wives, more equitable gender attitudes were positively associated with contraceptive use. For husbands, the role of gender attitudes had no significant association with wives' reported contraceptive use. Family planning programmes that aim to challenge inegalitarian gender norms should not overlook women in their efforts since both men and women often accept and support inequality in a social system and, in some cases, it may be women's gender attitudes that most influence family planning decisions.

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

    PubMed Central

    de Arruda, Guilherme Oliveira; Marcon, Sonia Silva

    2016-01-01

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

  5. Factors Associated with Hormonal and Intrauterine Contraceptive Use among HIV-Infected Men and Women in Lilongwe, Malawi: A Cross-Sectional Study.

    PubMed

    Tang, Jennifer H; Phiri, Sam; Ng'ambi, Wingston; Krashin, Jamie W; Mlundira, Linly; Chaweza, Thom; Samala, Bernadette; Tweya, Hannock; Hosseinipour, Mina C; Haddad, Lisa B

    2016-01-01

    Background. Understanding the factors associated with the use of hormonal and intrauterine contraception among HIV-infected men and women may lead to interventions that can help reduce high unintended pregnancy rates. Materials and Methods. This study is a subanalysis of a cross-sectional survey of 289 women and 241 men who were sexually active and HIV-infected and were attending HIV care visits in Lilongwe, Malawi. We estimated adjusted prevalence ratios (PRs) to evaluate factors associated with hormonal and intrauterine contraceptive use for men and women in separate models. Results and Discussion. 39.8% of women and 33.2% of men (p = 0.117) reported that they were using hormonal or intrauterine contraception at last intercourse. Having greater than 3 children was the only factor associated with hormonal and intrauterine contraceptive use among men. Among women, younger age, not wanting a pregnancy in 2 years, being with their partner for more than 4 years, and being able to make family planning decisions by themselves were associated with hormonal and intrauterine contraceptive use. Conclusions. The men and women in our study population differed in the factors associated with hormonal and intrauterine contraceptive use. Understanding these differences may help decrease unmet FP needs among HIV-infected men and women. PMID:27642245

  6. Factors Associated with Hormonal and Intrauterine Contraceptive Use among HIV-Infected Men and Women in Lilongwe, Malawi: A Cross-Sectional Study

    PubMed Central

    Phiri, Sam; Ng'ambi, Wingston; Krashin, Jamie W.; Mlundira, Linly; Chaweza, Thom; Samala, Bernadette; Tweya, Hannock; Hosseinipour, Mina C.; Haddad, Lisa B.

    2016-01-01

    Background. Understanding the factors associated with the use of hormonal and intrauterine contraception among HIV-infected men and women may lead to interventions that can help reduce high unintended pregnancy rates. Materials and Methods. This study is a subanalysis of a cross-sectional survey of 289 women and 241 men who were sexually active and HIV-infected and were attending HIV care visits in Lilongwe, Malawi. We estimated adjusted prevalence ratios (PRs) to evaluate factors associated with hormonal and intrauterine contraceptive use for men and women in separate models. Results and Discussion. 39.8% of women and 33.2% of men (p = 0.117) reported that they were using hormonal or intrauterine contraception at last intercourse. Having greater than 3 children was the only factor associated with hormonal and intrauterine contraceptive use among men. Among women, younger age, not wanting a pregnancy in 2 years, being with their partner for more than 4 years, and being able to make family planning decisions by themselves were associated with hormonal and intrauterine contraceptive use. Conclusions. The men and women in our study population differed in the factors associated with hormonal and intrauterine contraceptive use. Understanding these differences may help decrease unmet FP needs among HIV-infected men and women. PMID:27642245

  7. Factors Associated with Hormonal and Intrauterine Contraceptive Use among HIV-Infected Men and Women in Lilongwe, Malawi: A Cross-Sectional Study

    PubMed Central

    Phiri, Sam; Ng'ambi, Wingston; Krashin, Jamie W.; Mlundira, Linly; Chaweza, Thom; Samala, Bernadette; Tweya, Hannock; Hosseinipour, Mina C.; Haddad, Lisa B.

    2016-01-01

    Background. Understanding the factors associated with the use of hormonal and intrauterine contraception among HIV-infected men and women may lead to interventions that can help reduce high unintended pregnancy rates. Materials and Methods. This study is a subanalysis of a cross-sectional survey of 289 women and 241 men who were sexually active and HIV-infected and were attending HIV care visits in Lilongwe, Malawi. We estimated adjusted prevalence ratios (PRs) to evaluate factors associated with hormonal and intrauterine contraceptive use for men and women in separate models. Results and Discussion. 39.8% of women and 33.2% of men (p = 0.117) reported that they were using hormonal or intrauterine contraception at last intercourse. Having greater than 3 children was the only factor associated with hormonal and intrauterine contraceptive use among men. Among women, younger age, not wanting a pregnancy in 2 years, being with their partner for more than 4 years, and being able to make family planning decisions by themselves were associated with hormonal and intrauterine contraceptive use. Conclusions. The men and women in our study population differed in the factors associated with hormonal and intrauterine contraceptive use. Understanding these differences may help decrease unmet FP needs among HIV-infected men and women.

  8. Fertility and contraceptive adoption and discontinuation in rural Kenya.

    PubMed

    Ferguson, A G

    1992-01-01

    After a long period of slow progress, the recent uptake of contraceptive use in Kenya has been dramatic. This report describes adoption of a method and method switching and discontinuation among a cohort of married women aged 25-34 in two contrasting rural areas. A retrospective "fertility diary" completed by each woman provided information on spousal separation, reproductive status, and contraceptive use over a period of 46-48 months. Contraceptive prevalence rose rapidly over the period in both areas, with significant net adoption of injectables in both areas and of IUDs in one only. Method discontinuation was concentrated among users of pills, barrier methods, and "natural" methods, and only one-third of all discontinuations were voluntary. The wide differences between the two rural areas in contraceptive prevalence were not totally reflected in recent fertility levels, and the contribution of other proximate determinants of fertility, particularly postpartum amenorrhea and spousal separation, are discussed.

  9. Use of contraception and abortion in Greece: a review.

    PubMed

    Ioannidi-Kapolou, Elizabeth

    2004-11-01

    Greece has one of the highest rates of abortions in Europe and a very low prevalence of contraceptive use apart from withdrawal and condoms. Based on limited data from the past 30 years, this paper describes the context in which Greek women make reproductive decisions, and the history of family planning and abortion policies and services in Greece. It shows that in spite of the persistence of the traditional importance placed on marriage and motherhood, the fertility rate in Greece is very low. Sex education is still not included in the school curriculum, and the lack of accurate information on contraception and the prevention of unwanted pregnancy, especially in adolescence, still have critical repercussions for women's life choices. Although the public sector has been required to provide family planning services since 1980, only 2% of women of reproductive age were accessing these services in 1990, based mainly in urban centres. In 2001, one in four women of reproductive age had had at least one unwanted pregnancy ending in abortion; the rate was one in ten in the 16-24 age group and one in three in the 35-45 age group. With an almost complete lack of preventive policies in Greece, women continue to have to rely on abortion to control births. PMID:15938171

  10. Prevalence and Incidence Rates of Dementia and Cognitive Impairment No Dementia in the Mexican Population

    PubMed Central

    Mejia-Arango, Silvia; Gutierrez, Luis Miguel

    2012-01-01

    Objective To estimate the prevalence and incidence of dementia and cognitive impairment without dementia (CIND) in the Mexican population. Methods The MHAS study is a prospective panel study of health and aging in Mexico with 7,000 elders that represent 8 million subjects nationally. Using measurements of cognition and activities of daily living of dementia cases and CIND were identified at baseline and follow up. Overall incidence rates and specific rates for sex, age and education were calculated. Results Prevalence was 6.1% and 28.7% for dementia and CIND, respectively. Incidence rates were 27.3 per 1,000 person-years for dementia and 223 per 1,000 persons-year for CIND. Rates of dementia and CIND increased with advancing age and decreased with higher educational level; sex had a differential effect depending on the age strata. Hypertension, diabetes and depression were risk factors for dementia but not for CIND. Discussion These data provide estimates of prevalence and incidence of dementia and cognitive impairment in the Mexican population for projection of future burden. PMID:21948770

  11. Contraception and Birth Control

    MedlinePlus

    ... health, age, frequency of sexual activity, number of sexual partners, desire to have children in the future, and family history of certain diseases. Individuals should consult their health care provider to ... methods of contraception include: Barrier —physically ...

  12. Post abortion contraception.

    PubMed

    Gemzell-Danielsson, Kristina; Kopp, Helena Kallner

    2015-11-01

    A safe induced abortion has no impact on future fertility. Ovulation may resume as early as 8 days after the abortion. There is no difference in return to fertility after medical or surgical abortion. Most women resume sexual activity soon after an abortion. Contraceptive counseling and provision should therefore be an integrated part of the abortion services to help women avoid another unintended pregnancy and risk, in many cases an unsafe, abortion. Long-acting reversible contraceptive methods that includes implants and intrauterine contraception have been shown to be the most effective contraceptive methods to help women prevent unintended pregnancy following an abortion. However, starting any method is better than starting no method at all. This Special Report will give a short guide to available methods and when they can be started after an induced abortion.

  13. Post abortion contraception.

    PubMed

    Gemzell-Danielsson, Kristina; Kopp, Helena Kallner

    2015-11-01

    A safe induced abortion has no impact on future fertility. Ovulation may resume as early as 8 days after the abortion. There is no difference in return to fertility after medical or surgical abortion. Most women resume sexual activity soon after an abortion. Contraceptive counseling and provision should therefore be an integrated part of the abortion services to help women avoid another unintended pregnancy and risk, in many cases an unsafe, abortion. Long-acting reversible contraceptive methods that includes implants and intrauterine contraception have been shown to be the most effective contraceptive methods to help women prevent unintended pregnancy following an abortion. However, starting any method is better than starting no method at all. This Special Report will give a short guide to available methods and when they can be started after an induced abortion. PMID:26619082

  14. Contraceptive knowledge, sexual behavior, and factors associated with contraceptive use among female undergraduate university students in Kilimanjaro region in Tanzania

    PubMed Central

    Sweya, Mussa N; Msuya, Sia E; Mahande, Michael J; Manongi, Rachel

    2016-01-01

    Background Previous studies have shown that knowledge of contraceptives, especially among the youth in universities, remains limited, and the rate of premarital sexual activity, unwanted pregnancies, and illegal abortions remains higher among university students. This study aimed to assess contraceptive knowledge, sexual behavior, and factors associated with contraceptive use among female undergraduate university students in Kilimanjaro region in Tanzania. Methods A cross-sectional analytical study was conducted from May to June 2015 among undergraduate female students in four universities in Kilimanjaro region. A self-administered questionnaire was given to the participants. Data analysis was performed using Statistical Package for Social Sciences. Descriptive statistics were used to summarize the data. An odds ratio with 95% confidence interval for factors associated with modern contraceptive use was computed using multiple logistic regression models. A P-value of <5% (two-tailed) was considered statistically significant. Results A total of 401 students were involved in the study. Two-thirds (260, 64.8%) of the participants had had sexual intercourse. The majority (93.8%) of the participants had knowledge of contraception. One hundred and seventy-five (43.6%) sexually active women reported that they used contraceptives in the past, while 162 (40.4%) were current contraceptive users. More than half (54.2%) of the sexually active group started sexual activity between the ages of 20–24 years. The most popular methods of contraception used were condoms, withdrawal, and periodic abstinence. The main sources of information about contraception were friends, television, and health care workers (44.8%, 40.3%, and 39.0%, respectively). Conclusion Most of the participants had knowledge of contraception. However, the rate of contraceptive use was low. The majority of the respondents were sexually active and started sexual activity at >18 years of age. Hence, advocacy for

  15. Oral contraceptives and dysmenorrhea.

    PubMed

    Cholst, I N; Carlon, A T

    1987-01-01

    This artical examines the risks and benefits associated with use of the oral contraceptive pill (OCP) by adolescents and the various alternatives and methods of prescribing OCPs. Any adolescent who is either sexually active or contemplating sexual activity should be offered a contraceptive method that is appropriate to her individual needs. The contraceptive needs to be highly effective, safe and within the means and desires of the adolescent. For the majority of teenagers, the contraceptive of choice will be the OCP. The IUD should almost never be prescribed to the adolescent. Most OCPs marketed today are combination pills containing both an estrogen and a progestin in each pill. A variety of contraceptive actions combines to create a contraceptive method that is 99.3-99.9% effective. OCPs provide some protection against the development of pelvic inflammatory disease (PID). Oral contraceptives also decrease the incidence of anemia by decreasing the amount and duration of menstrual flow. Ovarian cysts do not form in the ovaries of the OCP user. On the other hand, a serious risk of the use of OCPs is the increased danger of thromboembolic events including deep venous thrombosis, pulmonary embolus, and myocardial infarction. The increased risk of myocardial infarction in OCP users is additive with other risk factors including hypertension, hypercholesterolemia, cigarette smoking, obesity, diabetes mellitus, and age. OCP use seems to provide some protection against development of endometrial or ovarian cancer. Oral contraceptives are associated with the development of benign hepatocellular adenomas. A variety of metabolic and hormonal alterations also occur in pill users. Most appropriate for the adolescent is a formulation containing a low dose of estrogen because of the decreased risk of thromboembolic complications. Dysmenorrhea effects more than 1/2 of female adolescents, and can best be treated with ibuprofen.

  16. The Epidemiology of Benign Prostatic Hyperplasia Associated with Lower Urinary Tract Symptoms: Prevalence and Incident Rates.

    PubMed

    Egan, Kathryn Brigham

    2016-08-01

    This article assesses the reported prevalence and incidence rates for benign prostatic hyperplasia and lower urinary tract symptoms (BPH/LUTS) by age, symptom severity, and race/ethnicity. BPH/LUTS prevalence and incidence rates increase with increasing age and vary by symptom severity. The BPH/LUTS relationship is complex due to several factors. This contributes to the range of reported estimates and difficulties in drawing epidemiologic comparisons. Cultural, psychosocial, economic, and/or disease awareness and diagnosis factors may influence medical care access, symptom reporting and help-seeking behaviors among men with BPH/LUTS. However, these factors and their epidemiologic association with BPH/LUTS have not been thoroughly investigated. PMID:27476122

  17. History of oral contraception.

    PubMed

    Dhont, Marc

    2010-12-01

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

  18. History of oral contraception.

    PubMed

    Dhont, Marc

    2010-12-01

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

  19. Evaluative Indices Assigned to Contraceptive Methods by University Undergraduates

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  20. Contraceptive strategies for young women in the 21st century.

    PubMed

    Ruusuvaara, L; Johansson, E D

    1999-12-01

    Safe, effective and affordable contraceptives have been available for a few decades, yet, in many countries, the struggle for reproductive rights continues. Children, still, are forced to give birth to children in many nations. In most industrialized countries, where contraceptive counselling and abortions have been options, fertility rates have reached all time lows. Effective contraception improves health and well-being as well and may be used for conditions other than birth control. Young girls often initially take oral contraceptives primarily to reduce menstrual pain and blood loss; they also welcome a contraceptive that eliminates menstrual bleeding. Women using oral contraceptives and Norplant experience about 50% reduction in menstrual blood; 90% reduction in blood loss is achieved with the levonorgestrel intrauterine system (Mirena). Teenagers and their parents are often misinformed about the side-effects of oral contraceptives and birth control in general, which may adversely affect compliance. Adequate, user-friendly and supportive information about contraception is necessary to ensure proper use of the pill and other birth control methods. In addition, emergency contraceptives should be easily accessible. The mortality and morbidity of young women would be dramatically reduced by the global use of medical abortion as well. Only a combined effort by policy makers, educators, parents and health-care providers can enhance the reproductive (and future!) health of both young females and males.

  1. 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…

  2. 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.

  3. 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.

  4. 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.

  5. Introducing new contraceptives.

    PubMed

    Segal, S J; Coutinho, E

    1986-12-01

    At this time, private research efforts to discover new contraceptives are threatened. Drug companies, particularly in the US, have reduced their interest in contraceptive development due to concern over the rising cost of product liability insurance, the cost of lawsuits in defense of liability claims, and the fear of extremely high awards by juries in product liability cases. The current form of private-public collaboration, now threatened by the liability crisis, works under a few simple principles of agreement. Private industry agrees to supply its patented chemical compounds for assessment as contraceptive agents, to be willing to enter into negotiations with public sector organizations to develop the contraceptive drugs if initial tests warrant it, and to release compounds to another company if the patent-holder declines to proceed with contraceptive development. The public-sector program agrees to fund the studies, keep the industry informed, and maintain confidentiality. When the technology is discovered by the public sector and is of potential interest to private industry, the collaboration involves other issues. The public agency agrees to supply manufacturing know-how and all biological and clinical information, to license under applicable patents, and to permit cross reference to regulatory agency filings. Private industry agrees to use its best efforts to bring the product to market, to manufacture the product at reduced cost for public sector use, or to provide know-how for others to do so. It also agrees to assume product liability and to grant the public sector agency licenses to any patented improvement in its product. Contraceptive research both within and outside the US is feeling the effects of the US litigious atmosphere. Companies from abroad now wish to steer clear of contraceptive research, even though these companies would be prepared to meet the requirements of the Food and Drug Administration. Contraceptives, considered to be high risk

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

    PubMed Central

    Stevens, Jennifer P.

    2016-01-01

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

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

    PubMed Central

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

    2013-01-01

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

  8. Contraceptive options for adolescents.

    PubMed

    Moriarty, A L

    1997-01-01

    Data on national trends of sex behavior indicate that adolescents in the US are initiating sexual activity at younger ages than in the past several decades. The 1996 Centers for Disease Control Youth Behavior Survey found that 36.9% of 9th graders and 66.4% of 12th graders had been sexually active. Of those, 37.9% were sexually active within the 3 months preceding the survey. 12.7% of the sexually active boys and 4.9% of the sexually active girls reported beginning sexual activity before age 13 years. 72% of individuals aged 15-17 years and 84% of those aged 18-19 report using some form of contraception. However, many use contraception inconsistently. The most popular and effective methods of contraception chosen by adolescents are condoms, oral contraception, and depot medroxyprogesterone acetate (DMPA). These methods are discussed. Before either oral contraceptive pill or DMPA use is initiated, a detailed health history should be taken and a complete physical examination conducted which includes a pelvic examination.

  9. Contraception for Adolescents: Focusing on Long-Acting Reversible Contraceptives (LARC) to Improve Reproductive Health Outcomes

    PubMed Central

    Salcedo, Jennifer

    2015-01-01

    Adolescent pregnancy rates in the U.S. have reached an all-time low from their peak in the 1980s and 1990s. However, the U.S. maintains the highest rate of teenage pregnancy among developed nations. Adolescents experience higher typical use failure rates for user-dependent contraceptives compared to their adult counterparts. Long-acting reversible contraception (LARC), IUDs and implants, have failure rates that are both very low and independent of user age. In settings where the most effective methods are prioritized and access barriers are removed, the majority of adolescents initiate LARC. Use of LARC by adolescents significantly reduces rates of overall and repeat teen pregnancy. All methods of contraception are safe for use in teens, including IUDs and DMPA. Dual use of LARC and barrier methods to reduce risk of sexually transmitted infection, is the optimal contraceptive strategy for most adolescents. Adolescent access to evidence-based and confidential contraceptive services, provided in a manner that respects autonomy, is a vital public health goal.

  10. Contraception for Adolescents: Focusing on Long-Acting Reversible Contraceptives (LARC) to Improve Reproductive Health Outcomes

    PubMed Central

    Salcedo, Jennifer

    2015-01-01

    Adolescent pregnancy rates in the U.S. have reached an all-time low from their peak in the 1980s and 1990s. However, the U.S. maintains the highest rate of teenage pregnancy among developed nations. Adolescents experience higher typical use failure rates for user-dependent contraceptives compared to their adult counterparts. Long-acting reversible contraception (LARC), IUDs and implants, have failure rates that are both very low and independent of user age. In settings where the most effective methods are prioritized and access barriers are removed, the majority of adolescents initiate LARC. Use of LARC by adolescents significantly reduces rates of overall and repeat teen pregnancy. All methods of contraception are safe for use in teens, including IUDs and DMPA. Dual use of LARC and barrier methods to reduce risk of sexually transmitted infection, is the optimal contraceptive strategy for most adolescents. Adolescent access to evidence-based and confidential contraceptive services, provided in a manner that respects autonomy, is a vital public health goal. PMID:27635305

  11. Contraceptive problems unique to the United States.

    PubMed

    Tyrer, L B; Salas, J E

    1989-06-01

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

  12. Husband's approval of contraceptive use in metropolitan Indonesia: program implications.

    PubMed

    Joesoef, M R; Baughman, A L; Utomo, B

    1988-01-01

    Husband's approval of contraceptive use plays a decisive role in Indonesia. Despite this, no previous study of contraceptive use in Indonesia has evaluated the importance of husband's approval. Such evaluation is especially important in metropolitan areas where family planning programs have encountered more difficulty than those elsewhere in recruiting contraceptive users. Using data from the first Indonesia Contraceptive Prevalence Survey for metropolitan cities, husband's approval and other determinants of contraceptive use among fecund women were evaluated. The levels of contraceptive use varied among cities, ranging from 34.2 percent in Ujung Pandang to 56.5 percent in Semarang. For all cities, however, husband's approval was the most important determinant, followed by number of living children and wife's education. Among women who desire to have no more children, 17.4 percent and 27.8 percent of contraceptive nonuse in Medan and Jakarta, respectively, was attributable to husband's disapproval. Because most of the family planning programs in Indonesia are designed to serve primarily women, the finding of husband's approval as the most important determinant has important program implications. PMID:3406964

  13. Statistical approach for evaluation of contraceptive data.

    PubMed

    Tripathi, Vriyesh

    2008-04-01

    This article will define how best to analyse data collected from a longitudinal follow up on contraceptive use and discontinuation, with special consideration to the needs of developing countries. Accessibility and acceptability of contraceptives at the ground level remains low and it is an overlooked area of research. The author presents a set of propositions that are closer in spirit to practical recommendations than to formal theorems. We will comment specifically on issues of model validation of model through bootstrapping techniques. The paper makes a presentation of a multivariate model to assess the rate of discontinuation of contraception, while accounting for the possibility that there may be factors that influence both a couple's choice of provider and their probability of discontinuation.

  14. Statistical approach for evaluation of contraceptive data.

    PubMed

    Tripathi, Vriyesh

    2008-04-01

    This article will define how best to analyse data collected from a longitudinal follow up on contraceptive use and discontinuation, with special consideration to the needs of developing countries. Accessibility and acceptability of contraceptives at the ground level remains low and it is an overlooked area of research. The author presents a set of propositions that are closer in spirit to practical recommendations than to formal theorems. We will comment specifically on issues of model validation of model through bootstrapping techniques. The paper makes a presentation of a multivariate model to assess the rate of discontinuation of contraception, while accounting for the possibility that there may be factors that influence both a couple's choice of provider and their probability of discontinuation. PMID:20695150

  15. Local ecological factors, ultrafine particulate concentrations, and asthma prevalence rates in Buffalo, New York, neighborhoods.

    PubMed

    Lwebuga-Mukasa, Jamson S; Oyana, Tonny J; Johnson, Caryn

    2005-06-01

    Previous to this study various healthcare utilization studies and house-to-house surveys had shown that Buffalo's west side had a high utilization rate for asthma and high asthma prevalence in comparison with neighboring communities. The relative contributions of traffic-related pollution and personal and local ecological factors to the high asthma rates were still unknown. To investigate the potential roles of personal home environmental factors and local ecological factors in variations of asthma prevalence in Buffalo neighborhoods, we conducted a cross-sectional survey of a systematic random sample of 2000 households in the city of Buffalo, New York, with a response rate of 80.4%. We found that the odds of having at least one person with asthma per household on Buffalo's west side was 2.57 times [95% confidence interval (CI)=1.85-3.57] that of Buffalo's east side. There were no statistically significant differences in the odds of finding at least one person with asthma in households of other Buffalo neighborhoods. We further found no difference in the odds of having asthma on Buffalo's west side even after correcting for race/ethnicity, household triggers of asthma, and socioeconomic factors. Monitoring ultrafine particulates showed increased levels in communities downwind of the Peace Bridge Complex and major roadways supplying it. A multiple-regression model showed that asthma prevalence may be influenced by humidity and ultrafine particulate concentrations. These results suggest that increased asthma risk may be influenced by chronic exposure to personal and local ecological factors. PMID:16036408

  16. 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

  17. Prevalence and mortality rate of peste des petitis ruminant (PPR): possible association with abortion in goat.

    PubMed

    Abubakar, Muhammad; Ali, Qurban; Khan, Haider A

    2008-06-01

    Present study was designed to investigate the prevalence and mortality (%) caused by Peste des Petitis Ruminant (PPR) and its possible association with abortion in goat flocks at different areas of Pakistan. A total of 140 animals were samples in the population of 650 which was having 185 deaths (Mortality rate = 28 %) from three different regions of the country. There were 58 abortions in the 140 pregnant goats of above said population One hundred & ten (110) serum samples from diseased, recovered and apparently healthy animals were tested for the presence of PPR antibodies by competitive ELISA (c ELISA). Eighty-four (84) animals were positive for PPR antibodies whereas in apparently healthy adult goats in the same flock, no PPR antibodies were detected. Twenty-four (24) tissue samples collected from the dead animals and six samples from aborted fetus were tested for the presence of PPR antigen by Immuno-capture ELISA (Ic ELISA). Nineteen (19) out of thirty (30) organ samples mainly from lung, spleen, lymph node were found positive for PPR antigen but negative from lungs of aborted fetus. There was a high rate of abortions (28-45%) in each of the outbreak and it was highest in the outbreak of Golra Sharif, Islamabad (No. = 21 in total population of 100). As the serum samples from the aborted dams were found positive for PPR antibodies so the study provides the possible association of mortality and prevalence of PPR disease with high rate of abortions in goat.

  18. Rates of Prevalent HIV Infection, Prevalent Diagnoses, and New Diagnoses Among Men Who Have Sex With Men in US States, Metropolitan Statistical Areas, and Counties, 2012-2013

    PubMed Central

    Sanchez, Travis Howard; Sullivan, Patrick Sean

    2016-01-01

    Background In the United States, men who have sex with men (MSM) increasingly represent the majority of people living with and acquiring human immunodeficiency virus (HIV) infection. Local and federal surveillance programs estimate the number of persons living with an HIV diagnosis, persons living with HIV infection, and new diagnoses. Given the absence of population-based estimates of the number of MSM for US states, metropolitan statistical areas (MSAs), or counties, it is not possible to accurately estimate rates using these indicators at these levels, inhibiting the ability to understand HIV burden and to direct prevention efforts. Objective To synthesize recently published estimates of MSM population size with publicly available HIV surveillance data, in order to estimate the prevalence of HIV diagnosis and infection and the rate of new diagnoses, at the national, state, MSA, and county levels. Methods The number of MSM living with HIV infection in 2012 (prevalence), living with an HIV diagnosis in 2012 (diagnosed prevalence), and newly diagnosed with HIV infection in 2013 (new diagnosis), at state, MSA, and county levels, were obtained from publicly available data from AIDSVu.org and the US Centers for Disease Control and Prevention. The estimated number of MSM living in every US county was calculated using recently published methodology that utilized data from the National Health and Nutrition Examination Survey and American Community Survey. Estimated county-level MSM counts were aggregated to form MSA- and state-level totals. From this, we estimated HIV prevalence, diagnosed prevalence, and new diagnosis rates. Results The estimated HIV prevalence among MSM in the United States in 2012 was 15.0% (666,900/4,452,772), the diagnosed HIV prevalence in 2012 was 11.1% (493,453/4,452,772), and the new diagnosis rate for 2013 was 0.7 per 100 MSM. For diagnosed prevalence at the state level, 6 states had both <15,000 cases and diagnosed prevalence rates of ≥15

  19. Prevalence rate of supernumerary teeth among non-syndromic South Indian population: An analysis

    PubMed Central

    Mahabob, M. Nazargi; Anbuselvan, G. J.; Kumar, B. Senthil; Raja, S.; Kothari, Sucitha

    2012-01-01

    Aim: Supernumerary teeth are considered as one of the most significant dental anomalies during the primary and early mixed dentition stage. The main objective of the study was to determine the prevalence rate of supernumerary teeth in the patients who reported to the Department of Oral Medicine and Radiology and to study the associated clinical complications. Materials and Methods: A longitudinal observational study was conducted of 2216 patients for a period of 4 months with the documentation of demographic data, the presence of supernumerary teeth, their location, and associated complications such as mechanical trauma, dental caries, and associated pathology. Results: The study recorded 27 supernumerary teeth from the examined 2216 patients. This yields a prevalence of 1.2%, with greater frequency in males which was 1.49% and in females the frequency was 0.85%. The greatest proportion of supernumerary teeth was found in the maxillary anterior region (77.8%). Out of this, 85.7% were classified as mesiodens based on their location. The displacement of adjacent teeth was the most common finding, followed by dental caries. Conclusion: The prevalence of supernumerary teeth in this study was 1.2% which is in agreement with that reported in similar studies and the maxillary mesiodens was the most common location. Displacement of adjacent teeth was the most common finding. PMID:23066293

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed

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

    2013-06-01

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

  2. [Test your knowledge: contraceptives].

    PubMed

    1998-06-01

    A brief self-administered quiz on contraceptive knowledge is presented. The 7 questions ask the reader to explain the mechanism of action of combined oral contraceptives, and why estrogens are used with progestins, and to indicate the main secondary effects of Depo-Provera and implants and the dosage of the "morning-after pill." A multiple-choice question concerns absolute contraindications to combined OC use. One clinical case involves selection of OCs for a woman with a family history of breast cancer and the other requires development of a strategy for reducing high-risk pregnancies and risk of AIDS.

  3. Male contraception: a clinically-oriented review.

    PubMed

    Kanakis, George A; Goulis, Dimitrios G

    2015-01-01

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

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

    PubMed Central

    Mruk, Dolores D.; Cheng, C. Yan

    2014-01-01

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

  5. 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…

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

    PubMed

    Klaus, Hanna; Cortés, Manuel E

    2015-08-01

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

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

    PubMed Central

    Klaus, Hanna; Cortés, Manuel E.

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Levinson, Ruth Andrea

    1995-01-01

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

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

    PubMed

    Boye, Joyce Irene

    2012-01-01

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

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

    PubMed Central

    2012-01-01

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

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

    PubMed

    Boye, Joyce Irene

    2012-01-01

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

  12. The use of contraception among abortion applicants.

    PubMed

    Krishnamoni, D; Jain, S C

    1985-01-01

    consisted mainly of young women whose parental attitude had deterred them from seeking help with birth control. The 181 women who had used some form of contraception within the last 6 months or earlier but not at the time of conception were mainly over age 17. More than half of them were unmarried. Less than 1/3 had elementary school education, and half had high school or more education. The complaint of side effects caused by the method was the most common reason for non-use among this group. In most instances the method complained about was oral contraception. More than half of the consistent users were married and almost 3/4 had high school or better education. The contraceptive that appears to have had the highest failure rate among the consistent users was the condom. Almost 1/3 of the women claimed that they had depended on the condom. The oral contraceptive, the IUD, and irreversible methods such as tubal ligation and vasectomy had a failure rate of 2% each. PMID:4005776

  13. Contraceptive Beach Ball

    ERIC Educational Resources Information Center

    Ellis, Edith B.; Miller, Deborah A.

    2005-01-01

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

  14. Current contraceptive research.

    PubMed

    Benditt, J M

    1980-01-01

    No contraceptive panacea is near or likely. The most exciting prospect, man-made analogs of LHRH (a brain hormone) for both male and female use, could not be available before the late 1980s. Other potential methods in human trials face serious obstacles. PMID:6995149

  15. Prescription contraceptives: countering the risks.

    PubMed

    Ruggiero, R J

    1985-09-01

    Drug companies have been at work throughout the 1960s, 1970s, and 1980s trying to reduce the steroid content of their oral contraceptives (OCs). Researchers have been successful in reducing steroid content while maintaining effectiveness, thereby making OCs safer. In the 1st half of the natural menstrual cycle, a woman secretes estrogen as the dominant steroid product. In the 2nd half, estrogen is the principal reproductive hormone. Estrogens inhibit ovulation, possibly by inhibiting implantation, altering ovum transplant, or in some way preventing corpus luteum function, which is necessary to maintain early pregnancies and the endometrium. There are still only 2 estrogens and 6 progestins on the market today. They are probably the most thoroughly studied chemical ever seen in the history of pharmacy or medicine. 1 of the estrogens, mestranol, is really a drug of the past. In the body, mestranol is converted to ethinyl estradiol, the other estrogen on the market. Consequently, there is no reason to use mestranol itself. Within the dose range of 50-100 mcg, there's little difference in contraceptive effect. Progestins are the other active ingredient in the combination OC. Their principal action is the thickening of the cervical mucus, which prevents sperm penetration. Also, with sufficient progesterone, ovulation is inhibited, but this happens in only 40% of those patients taking, for instance, the "mini-pill" (which consists of progesterone only). The progestins and the estrogens work in concert to make OCs a highly effective contraceptive method. Recent surveys conducted by the Centers for Disease Control and National Cancer Institute looked into the relative effectiveness of OCs. Nordette had a use effectiveness failure rate of 3.5; Ovral, 3.6. Loestrin 1/20 -- norethindrone acetate, 1 mg, and estinyl estradiol, 20 mcg -- shows a failure rate of 4.5. This indicates that the threshold for an effective dose of estinyl estradiol in OCs is 30 mcg. For 1 mini

  16. 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.

  17. Male contraceptives under trial.

    PubMed

    1975-02-01

    The International Planned Parenthood Federation held its 4th biological workshop in New Delhi on October 17-19, 1974. The topic of this meeting was "Agents affecting fertility in the male." 10 internationally known experts in the field of male reproductive physiology attended and each presented an up-to-the-minute account of their work in the field, followed by a full discussion. Much basic work was described, and the results of the latest human trials of male contraceptives were reported. Dr. F. Neumann of the Schering Company, Berlin, reported on clinical trials of the drug cyproterone acetate. This drug has been in the news for some time as a possible male contraceptive. It is found that small doses prevent sperm from maturing in the epididymis. This drug is already on the British market as Androcur. In large doses it is useful for curbing libido, and in this format it is used to control "sexual offenders." In the small doses at which it is useful as a contraceptive, the effects on libido are negligible, and the drug is at present undergoing human trials as a contraceptive agent. However, much work has still be done on, for example, long-term side effects. Another approach described by Dr. J. Frick from Innsbruck, Austria, is that of giving men a progestagen combined with testosterone. Whereas the progestagen has the effect of inhibiting sperm production in the testis, the testosterone compensates for androgen loss and maintains libido and male characteristics. Dr. Frick reported studies using 15 progestagen combinations, including a new drug provisionally titled R2323. The overall conclusion of the meeting was that there are still many problems to be solved, and it will be some years before a male contraceptive will be commercially available. PMID:12333962

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

    PubMed Central

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

    2016-01-01

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

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

    PubMed Central

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

    2016-01-01

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

  20. 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

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

    PubMed

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

    2014-11-01

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

  2. Prevalence and incidence rates of pressure ulcers in an Emergency Department.

    PubMed

    Dugaret, Elodie; Videau, Marie-Neige; Faure, Isabelle; Gabinski, Claude; Bourdel-Marchasson, Isabelle; Salles, Nathalie

    2014-08-01

    Older patients represent an increasing population in emergency department (ED) with underlying diseases and longer ED length of stay, which are potential risk factors of pressure ulcers (PUs). The aim of the study was to determine the prevalence and incidence rates of PUs in an Emergency Department and to analyse variables related to PUs occurrence. The study was carried out in the Emergency Department of Bordeaux (France), and included 602 patients from 1 to 15 June 2010. All the potential body sites of pressure were examined at admission and discharge for all the patients by trained nurses. Comorbidity score, list of treatment, length of stay (hours), PUs (including stage I) and C-reactive protein (CRP) level were systematically recorded. A total of 47 (7·8%) patients had prevalent PUs at admission and 74 (12·3%) at discharge. The cumulative incidence was 4·9% and the incidence density was 5·4 per 1000 patients per hour. In multivariate analysis, higher comorbidities (OR 1·3; P = 0·014) and CRP levels (OR 1·005; P = 0·017) were both independent risk factors for developing PU. In conclusion, these data show that even a very short stay to the ED is sufficient to induce PUs especially stage I.

  3. Contraception: traditional and religious attitudes.

    PubMed

    Schenker, J G; Rabenou, V

    1993-04-01

    Humans have tried to control fertility for centuries. Primitive, preliterate societies practiced infanticide and abortion. When primitive women understood the advantages of conception control, they tried, when possible, to use contraception. In the 4th century B.C., Plato and Aristotle advocated a one-child family. Greek medical literature reported a hollow tube inserted through the cervix into the uterus and a potion as contraceptives. Islamic physicians had much knowledge about conception control. The attitudes toward contraception. In the 5th century B.C., Saint Augustine condemned contraception, even among married couples. The condom emerged in the early modern period. Yet, they were usually worn to protect against disease, e.g., bilharzia in Egypt and syphilis in Europe. The cervical cap and the diaphragm are examples of occlusive pessaries. By 1880, contraceptives and spermicides were advertised. In 1928, the IUD joined the existing contraceptives. Today we have combined oral contraceptives. Judaic law requires husbands to fulfill their wives sexual needs, separate from their duty to procreate. It also calls men, not women, to procreate and forbids men from masturbating, thus Judaic law does not forbid women from practicing contraception. The Roman Catholic church forbids contraceptive use because it is a sin against nature. Some Protestant denominations have allowed contraceptive use. Islamic law states that children are gifts from Allah. Some Moslems believe that they must have many children, but Allah and the Prophet state that children have rights to education and future security. These rights allow couples to prevent pregnancy. Neither Hinduism nor Buddhism prohibit contraceptive use. Differences in husband-wife communication, sex roles, access to contraceptives, and traditional family values will have more of an effect on contraceptive use and fertility than theological barriers or the social class of religious groups.

  4. Sociodemographic determinants of contraceptive method choice in Sri Lanka: 1975-82.

    PubMed

    Kahn, J R; Thapa, S; Gaminiratne, K H

    1989-01-01

    The determinants of contraceptive method choice in Sri Lanka are examined during a period in which contraceptive prevalence increased by over 60% and involved substantial use of sterilization and traditional methods. Data are from the 1975 World Fertility and 1982 Contraceptive Prevalence Surveys. Polytomous logistic regression is used to model four current contraceptive choices: non-use, use of a traditional method, use of a modern temporary method and use of sterilization. The analysis shows, in 1975 and 1982, strong socioeconomic as well as demographic effects on whether any method is used. However, in both years the type of method chosen is primarily a function of demographic considerations related to the couple's family-building stage rather than social status, implying that in Sri Lanka there are few socioeconomic barriers limiting access to different contraceptive methods. The family planning programme, however, has emphasized sterilization rather than birth spacing methods.

  5. Postabortal and postpartum contraception.

    PubMed

    Cameron, Sharon

    2014-08-01

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

  6. The birth rate decline in developing countries.

    PubMed

    Robey, B

    1993-01-01

    Family planning programs historically have played an important role in providing information and counseling and supplying modern methods. Most programs are effective due to socioeconomic development and strong political support. Potential demand for services will be growing. This means that donor agencies must commit additional funding, and users must begin paying or paying more for contraceptives. Services and method choices need to be expanded, and quality of care needs to be improved. Three primary factors will impact on fertility decline: 1) the rate of social development, 2) the speed with which small family norms spread and contraception is adopted, and 3) the facility of private and public suppliers to meet contraceptive demand. Other factors influence reproductive decisions (women's roles and status, economic hardships or opportunities, religion, ethnicity, culture, and tradition). Contraceptive prevalence has increased from under 10% in the 1960s to 38% of all married, reproductive age women in the developing world, excluding China, which has contraceptive prevalence of 72%. Regional differences are wide. In Latin America, contraceptive use averages nearly 60% and ranges from over 50% in 10 countries and below 38% in Bolivia, Guatemala, and Haiti. Contraceptive prevalence is above average in Indonesia (50%), Sri Lanka (62%), and Thailand (68%) and just below average in Bangladesh (40%), India (45%), Philippines (34%), and Vietnam (53%). Sub-Saharan Africa has the lowest prevalence, except for Zimbabwe (45%), Botswana (35%), and Kenya (27%). 80% of current users rely on modern methods. In most surveyed countries, 20-30% of married women have unmet demand. Fertility decline, unmet demand, and contraceptive use have all been affected by the diffusion of ideas about the use of family planning and the small family norm. Innovators are usually high status, educated women, who spread their views to other social groups or geographic areas. The spread can be rapid

  7. Steroid contraceptive use and pregnancy outcome.

    PubMed

    Pardthaisong, T; Gray, R H; McDaniel, E B; Chandacham, A

    1988-07-01

    Contraceptive use in relation to pregnancy outcome was studied in 8,816 births in Chiang Mai, northern Thailand, by examination of newborn infants and interviews with their mothers. Four thousand twenty-three women used no contraception before the index pregnancy, 1,229 used the injectable contraceptive Depo Provera (DMPA), and 3,038 used oral contraceptives prior to or during pregnancy. No differences were observed between these groups with respect to still births, multiple pregnancies, and birthweight. Women who used oral contraceptives had unexpectedly low rates of major defects and may have been affected by self-selection bias, whereas the noncontraceptors had rates similar to other populations. There was a significantly increased association of polysyndactyly among infants of DMPA users relative to the other groups, which was most pronounced in offspring of women under age 30 years, and persisted after exclusion of subjects with a family history or infants with multiple abnormalities. However, in five out of the ten polysyndactyly cases, the last injection of DMPA occurred more than 9 months before conception, and only three cases had definite gestational exposure. The association of chromosomal anomalies was also significantly increased in infants of mothers who used DMPA. The unrelated nature of these defects, the lack of confirmation from other studies, the distant preconceptional exposure to DMPA in many cases, and chance effects due to multiple statistical comparisons make a causal association unlikely. Other birth defects that had been previously reported in some publications to be associated with progestational steroid exposure, such as neural tube defects, heart malformations, and limb reduction defects, were not found in this study.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. The metabolic impact of oral contraceptives.

    PubMed

    Krauss, R M; Burkman, R T

    1992-10-01

    The hormonal components of oral contraceptives exert major effects on plasma lipoprotein metabolism. Estrogens may increase production of plasma triglycerides, leading to increased levels of very low-density lipoproteins, but they may also reduce levels of cholesterol-enriched and potentially atherogenic intermediate- and low-density lipoproteins. Furthermore, estrogens increase levels of high-density lipoproteins (HDLs), particularly the HDL2 subspecies, an effect linked to reduced mortality rates from cardiovascular disease in postmenopausal women receiving hormone replacement therapy. All combination oral contraceptives in use in the United States tend to raise levels of plasma triglycerides, low-density lipoprotein, and HDL3 to varying degrees. In contrast, changes in HDL and HDL2 reflect the combined effects of estrogen dose and relative androgenicity of the progestin component. Although in general, the lipoprotein changes are greater in magnitude with higher dose oral contraceptive preparations, they can be significant in lower dose preparations as well. Oral contraceptives also affect carbohydrate metabolism, primarily through the activity of progestin. Studies have demonstrated insulin resistance, rises in plasma insulin, and relative glucose intolerance by means of curve analysis of glucose tolerance tests. These effects are far less pronounced with lower dose preparations and with formulations using the newer progestins.

  9. [Male contraception - the current state of knowledge].

    PubMed

    Zdrojewicz, Zygmynt; Kasperska, Karolina; Lewandowska, Marta

    2016-08-01

    Contraception is important from a health, psychological and socioeconomic point of view. Due to the fact that male-based contraceptive methods are mostly represented by condoms and vasectomy, researchers are working on the new solutions, which could let the men be more involved in a conscious family planning. In this review we will present the current state of knowledge on this subject. There is a lot going on in the field of hormonal contraception. Studies including testosterone, progestins, synthetic androgens and other derivatives are on a different stages of clinical trials and mostly demonstrate high efficacy rates. Recent discovers of Izumo and Juno proteins, essential for the fertilization process, give hope for an easily reversible, non-hormonal method. Researchers are also trying to interfere with the process of spermatogenesis using BRDT inhibitor - JQ1, or neutralize the sperm by injecting styrene maleic anhydride (SMA) into the lumen of the vas deferens. The other studies explore processes involved in proper sperm motility. A vaccine which induces an immune response to the reproductive system is also an interesting method. The latest research use ultrasound waves and mechanical device which blocks the patency of vas deferens. The aim of the study current state of knowledge male contraception.

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

    PubMed

    Pretell-Zárate, Eduardo A

    2013-07-01

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

  11. [Male contraception - the current state of knowledge].

    PubMed

    Zdrojewicz, Zygmynt; Kasperska, Karolina; Lewandowska, Marta

    2016-07-01

    Contraception is important from a health, psychological and socioeconomic point of view. Due to the fact that male-based contraceptive methods are mostly represented by condoms and vasectomy, researchers are working on the new solutions, which could let the men be more involved in a conscious family planning. In this review we will present the current state of knowledge on this subject. There is a lot going on in the field of hormonal contraception. Studies including testosterone, progestins, synthetic androgens and other derivatives are on a different stages of clinical trials and mostly demonstrate high efficacy rates. Recent discovers of Izumo and Juno proteins, essential for the fertilization process, give hope for an easily reversible, non-hormonal method. Researchers are also trying to interfere with the process of spermatogenesis using BRDT inhibitor - JQ1, or neutralize the sperm by injecting styrene maleic anhydride (SMA) into the lumen of the vas deferens. The other studies explore processes involved in proper sperm motility. A vaccine which induces an immune response to the reproductive system is also an interesting method. The latest research use ultrasound waves and mechanical device which blocks the patency of vas deferens. The aim of the study current state of knowledge male contraception. PMID:27590656

  12. [Male contraception - the current state of knowledge].

    PubMed

    Zdrojewicz, Zygmynt; Kasperska, Karolina; Lewandowska, Marta

    2016-08-01

    Contraception is important from a health, psychological and socioeconomic point of view. Due to the fact that male-based contraceptive methods are mostly represented by condoms and vasectomy, researchers are working on the new solutions, which could let the men be more involved in a conscious family planning. In this review we will present the current state of knowledge on this subject. There is a lot going on in the field of hormonal contraception. Studies including testosterone, progestins, synthetic androgens and other derivatives are on a different stages of clinical trials and mostly demonstrate high efficacy rates. Recent discovers of Izumo and Juno proteins, essential for the fertilization process, give hope for an easily reversible, non-hormonal method. Researchers are also trying to interfere with the process of spermatogenesis using BRDT inhibitor - JQ1, or neutralize the sperm by injecting styrene maleic anhydride (SMA) into the lumen of the vas deferens. The other studies explore processes involved in proper sperm motility. A vaccine which induces an immune response to the reproductive system is also an interesting method. The latest research use ultrasound waves and mechanical device which blocks the patency of vas deferens. The aim of the study current state of knowledge male contraception. PMID:27591451

  13. Contraceptive practice, unwanted pregnancies and induced abortion in Southwest Nigeria.

    PubMed

    Omideyi, Adekunbi Kehinde; Akinyemi, Akanni Ibukun; Aina, Olabisi Idowu; Adeyemi, Adebanjo Babalola; Fadeyibi, Opeyemi Abiola; Bamiwuye, Samson Olusina; Akinbami, Catherine Abiola; Anazodo, Amechi

    2011-01-01

    Despite widespread awareness of and access to modern contraception, high rates of unwanted pregnancies and abortions still persist in many parts of the world, even where abortion is legally restricted. This article explores perspectives on contraception and abortion, contraceptive decision-making within relationships, and the management of unplanned pregnancies. It presents findings from an exploratory qualitative study based on 17 in-depth interviews and 6 focus group discussions conducted in 2 locations in Nigeria in 2006. The results suggest that couples do not practice contraception consistently because of perceived side effects and partner objections. Abortion is usually resorted to because pregnancy was unwanted due to incomplete educational attainment, economic hardship, immaturity, close pregnancy interval, and social stigma. Males usually have greater influence in contraceptive-decision making than females. Though induced abortion is negatively viewed in the community, it is still common, and women usually patronise quacks to obtain such services. An abortion experience can change future views and decisions towards contraception. Family planning interventions should include access to and availability of adequate family planning information. Educational campaigns should target males since they play an important role in contraceptive decision-making.

  14. A comparison of pressure ulcer prevalence rates in nursing homes in the Netherlands and Germany, adjusted for population characteristics.

    PubMed

    Tannen, Antje; Bours, Gerrie; Halfens, Ruud; Dassen, Theo

    2006-12-01

    Annual pressure ulcer surveys in the Netherlands and Germany have shown remarkable differences in prevalence rates. We explored the differences between the two populations, and the degree to which these differences were associated with differences in prevalence. To this end, data from 48 Dutch and 45 German facilities (n = 9772) from 2003 were analyzed. The prevalence of pressure ulcers (excluding grade 1) was 12.5% in the Netherlands and 4.3% in Germany. After adjusting for age, sex, and other risk factors, the probability of developing a pressure ulcer of stage 2 or higher in Dutch nursing homes was three times greater than in German homes.

  15. 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.

  16. Advances in male hormonal contraception.

    PubMed

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

    2014-11-01

    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

  17. 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

  18. Contraception: a social revolution.

    PubMed

    Benagiano, Giuseppe; Bastianelli, Carlo; Farris, Manuela

    2007-03-01

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

  19. The relationship of arsenic levels in drinking water and the prevalence rate of skin lesions in Bangladesh.

    PubMed

    Tondel, M; Rahman, M; Magnuson, A; Chowdhury, I A; Faruquee, M H; Ahmad, S A

    1999-09-01

    To determine the relationship of arsenic-associated skin lesions and degree of arsenic exposure, a cross-sectional study was conducted in Bangladesh, where a large part of the population is exposed through drinking water. Four villages in Bangladesh were identified as mainly dependent on wells contaminated with arsenic. We interviewed and examined 1,481 subjects [Greater/equal to] 30 years of age in these villages. A total of 430 subjects had skin lesions (keratosis, hyperpigmentation, or hypopigmentation). Individual exposure assessment could only be estimated by present levels and in terms of a dose index, i.e., arsenic levels divided by individual body weight. Arsenic water concentrations ranged from 10 to 2,040 microg/L, and the crude overall prevalence rate for skin lesions was 29/100. After age adjustment to the world population the prevalence rate was 30. 1/100 and 26.5/100 for males and females, respectively. There was a significant trend for the prevalence rate both in relation to exposure levels and to dose index (p < 0.05), regardless of sex. This study shows a higher prevalence rate of arsenic skin lesions in males than females, with clear dose-response relationship. The overall high prevalence rate in the studied villages is an alarming sign of arsenic exposure and requires an urgent remedy.

  20. The relationship of arsenic levels in drinking water and the prevalence rate of skin lesions in Bangladesh.

    PubMed Central

    Tondel, M; Rahman, M; Magnuson, A; Chowdhury, I A; Faruquee, M H; Ahmad, S A

    1999-01-01

    To determine the relationship of arsenic-associated skin lesions and degree of arsenic exposure, a cross-sectional study was conducted in Bangladesh, where a large part of the population is exposed through drinking water. Four villages in Bangladesh were identified as mainly dependent on wells contaminated with arsenic. We interviewed and examined 1,481 subjects [Greater/equal to] 30 years of age in these villages. A total of 430 subjects had skin lesions (keratosis, hyperpigmentation, or hypopigmentation). Individual exposure assessment could only be estimated by present levels and in terms of a dose index, i.e., arsenic levels divided by individual body weight. Arsenic water concentrations ranged from 10 to 2,040 microg/L, and the crude overall prevalence rate for skin lesions was 29/100. After age adjustment to the world population the prevalence rate was 30. 1/100 and 26.5/100 for males and females, respectively. There was a significant trend for the prevalence rate both in relation to exposure levels and to dose index (p < 0.05), regardless of sex. This study shows a higher prevalence rate of arsenic skin lesions in males than females, with clear dose-response relationship. The overall high prevalence rate in the studied villages is an alarming sign of arsenic exposure and requires an urgent remedy. PMID:10464073

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

    PubMed

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

    2008-08-01

    Hypertension is highly prevalent in South Africa, resulting in high stroke mortality rates. Since obesity is very common among South African women, it is likely that obesity contributes to the hypertension prevalence. The aims were to determine whether black African women have higher blood pressures (BPs) than Caucasian women, and whether obesity is related to their cardiovascular risk. African (N=102) and Caucasian (N=115) women, matched for age and body mass index, were included. Correlations between obesity (total body fat, abdominal obesity and peripheral fat) and cardiovascular risk markers (haemodynamic parameters, lipids, inflammatory markers, prothrombotic factors, adipokines, HOMA-IR (homoeostasis model assessment insulin resistance)) were compared between the ethnic groups (adjusted for age, smoking, alcohol and physical activity). Comparisons between low- and high-BP groups were also made for each ethnic group. Results showed that African women had higher BP (P<0.01) with increased peripheral vascular resistance. Surprisingly, African women showed significantly weaker correlations between obesity measures and cardiovascular risk markers when compared to Caucasian women (specifically systolic BP, arterial resistance, cardiac output, fibrinogen, plasminogen activator inhibitor-1, leptin and resistin). Interestingly, the latter risk markers were also not significantly different between low- and high-BP African groups. African women, however, presented significant correlations of obesity with triglycerides, C-reactive protein and HOMA that were comparable to the Caucasian women. Although urban African women have higher BP than Caucasians, their obesity levels are weakly related to traditional cardiovascular risk factors compared to Caucasian women. The results, however, suggest a link with the development of insulin resistance. PMID:18432254

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

    PubMed

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

    2012-05-01

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

  3. Contraceptive advertising in the United States.

    PubMed

    Lebow, M A

    1994-01-01

    are media reluctance, government regulation, lack of consistent effort on the part of advertisers, and a lack of consensus in society about the importance of this issue. These limits are the symptoms of a society which has an unrealistic view of sexual activity. Therefore, contraceptive advertising alone will not change the US's high unintended pregnancy and abortion rates. PMID:7849538

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

    PubMed Central

    2014-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  6. Estrogen and Progestin (Oral Contraceptives)

    MedlinePlus

    ... of serious side effects from oral contraceptives, including heart attacks, blood clots, and strokes. This risk is higher for women over 35 years of age and heavy smokers (15 or more cigarettes per day). If you take oral contraceptives, you should not smoke.

  7. [Hormonal contraception in autoimmpne diseases].

    PubMed

    Matyszkiewicz, Anna; Jach, Robert; Rajtar-Ciosek, Agnieszka; Basta, Tomasz

    2016-01-01

    The onset and the course of autoimmune diseases is influenced among other factors by the sex hormones. Hormonal contraception might affect the course of the autoimmune disease. The paper summarises the manner of save application of hormonal contraception in patients with autoimmune disease. PMID:27526427

  8. [Chronic illness and contraception].

    PubMed

    Saarikoski, S

    1987-01-01

    In recent years sterilization that can cause problems of the psyche and marital life has been recommended much less frequently with respect to chronic diseases. As regards heart and hypertensive diseases pregnancy is always contraindicated in case of 3rd and 4th disease categories and sterilization is recommended according to the New York Heart Association. As far as 1st and 2nd category patients are concerned if the load carrying capacity is normal pregnancy could be undertaken. Combination pills are not recommended for contraception because they can cause fluid retention or increase the risk of thrombosis. If the patient has a higher-than-normal risk of developing thrombosis or infection, for instance, those who wear pacemakers only tablets containing progesterone or subdermal capsule implants can be used. In those with blood pressure problems the additional use of the IUD is also advised. Among diseases of neurological and psychic origin the effect of hormonal contraceptives is weakened by antiepileptics, but even in such cases older combination pills of larger doses of active ingredients can be employed. Migraine is exacerbated in 1/3 of patients; here IUDs can be used. Even the contraceptive tablets themselves can induce depression. In psychosis methods requiring regular attention can be easily forgotten, therefore the IUD is the most suitable device. In diabetes progesterone and other progestogens reduce insulin response, harm carbohydrate metabolism; therefore in young people the IUD is preferred an in older women with children even sterilization can be employed. Hormonal tablets must not be used in hyperlipidemia and liver diseases. Caution must be exercised in hyperthyroidism and in endocrine disorders (e.g., Cushing's syndrome); if it is accompanied by blood pressure disorders appropriate treatment is required. In kidney diseases pregnancy is contraindicated if it is accompanied by blood pressure increase or a higher level of creatine. On the other hand

  9. [Young men's contraceptive habits].

    PubMed

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

    1992-10-01

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

  10. The adolescent and contraception.

    PubMed

    Bonar, R W; Mcculla, D

    1981-08-01

    Coital activity is often initiated during adolescence, and adolescents, like many adults, do not behave in purely rational ways and frequently fail to protect themselves against undesired pregnancy. Public attention is focused on adolescent pregnancies because of their increasing number and because the consequences are usually catastrophic. Unplanned pregnancies can have physical, psychosocial, and prenatal effects. It is important from both the individual and societal perspective that high priority be given to the task of preventing adolescent pregnancy. The health care provider, to gain the trust of the adolescent, must be open, honest, and willing to consider the young person's feelings and motivations. In addition to historical data and physical examination, the choice of a contraceptive method is based on individual preferences involving personal, familial, religious, and societal beliefs as well as sexual practice. A decision involving birth control for the adolescent can be complicated by parental influence and involvement. The teenage years are frequently a time of embarrassment about the physical maturation and biological functioning of the body. Birth control methods which require a person to touch himself/herself or to be used at the time of sexual intercourse may be unacceptable to the teenager. Fertility awareness techniques, such as basal body temperature, rhythm, and cervical mucus methods are inexpensive but call for a high degree of personal motivation. The use of a diaphragm requires an office visit and a pelvic examination for fitting and prescription. Contraceptive foam, suppositories, and condoms can be easily obtained over-the-counter for a minimal cost, and a moderate degree of personal motivation is needed for their effective use. Though effective, abortions should not be recommended indiscriminately. Permanent contraceptive methods are not recommended for the adolescent. The IUD and oral contraceptives (OCs) are recommended for adolescents

  11. [Morality and contraception].

    PubMed

    Gakwaya, D

    1988-08-01

    The conflict of morality and natural law come into focus when contraception and procreation are examined despite the religious pronouncements of Charles de Koninck. Man, having mastered nature, confronts interminable new problems in the pursuit of physical, economic, moral, and material happiness. The population explosion in Rwanda make it indispensable that the prevention of undesired pregnancy is the right of a man and a women choosing the appropriate method. Man's morality allows the violation of natural law in order to pursue one's own goal of survival using counterbalancing means whenever under- or overpopulation may threaten its existence or portend extinction. Natural law could be the guiding principle in man's moral development.

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

    PubMed Central

    Çaglı, Bekir; Tekataş, Aslan; Kırıcı, 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

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

    PubMed

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

    2014-12-01

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

  14. 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.

  15. 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…

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

    ERIC Educational Resources Information Center

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

    2007-01-01

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

  17. European society of contraception statement on contraception in obese women.

    PubMed

    Merki-Feld, Gabriele S; Skouby, Sven; Serfaty, David; Lech, Medard; Bitzer, Johannes; Crosignani, Pier Giorgio; Cagnacci, Angelo; Sitruk-Ware, Regine

    2015-02-01

    The obesity 'epidemic' continues to increase, mostly but not only in developed countries. As overweight and obese women are at an increased risk for venous thromboembolism (VTE) at baseline and at a much higher risk during pregnancy, it is essential to help these women to plan pregnancies carefully and to use contraceptives with a positive ratio of benefits versus risks. The Expert Group on hormonal and molecular contraception of the European Society of Contraception convened to review the existing evidence and propose recommendations to the prescribers in line with most recent studies and with the Medical Eligibility Criteria of the World Health Organisation.

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

    PubMed

    Raut, Manoj Kumar

    2015-01-01

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

  19. The effects of contraception on female poverty.

    PubMed

    Browne, Stephanie P; LaLumia, Sara

    2014-01-01

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

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

    PubMed

    Wiszniewski, Adam; Bykowska, Ksenia; Bilski, Radoslaw; Jaśkowiak, 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.

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

    PubMed

    Mbabajende, V

    1986-04-01

    Because of contraception, pregnancy need not be viewed by women as punishment for sexual activity but as a planned and desired event. Most of the contraceptive methods used in developing countries at present were introduced during the 1960s, but use of contraception has a long history and some methods date back to antiquity. Contraceptive pills were already used around 2000 BC in the form of mercury and arsenic tablets. Their effectiveness was questionable. The role of hormones in human reproduction began to be understood only in the early 1900s. The discovery of progesterone in a Mexican iguana in the 1940s permitted production of progesterone on a large scale. Estrogens had been identified around 1930. Human trials of a contraceptive pill beginning in 1956 in Puerto Rico demonstrated that progestins could prevent pregnancy by suppressing ovulation. Later on, estrogen was added to reduce menstrual irregularities. The 1st generation of combined oral contraceptives contained very high levels of hormones associated with high rates of side effects. Numerous formulations with lower hormonal contents became available beginning around 1970 and constitute the principal formulations in use today. A number of long acting hormonal methods based on progestins have been developed, including injectables, some IUDs and vaginal rings, and implants. The 1st commercially available injectable, norethisterone enanthate, did not acquire the wide distribution of medroxyprogesterone acetate, sold as Depo Provera and used to treat various pathological conditions as well as for contraception. The 1st true IUDs were small stones placed within the uteri of camels by nomads to prevent pregnancy during long caravans. An IUD was developed in 1909 by Richter, and the 2 most widely used models before 1960 were the Grafenberg and Ota silver rings. Use of the 2 rings became rare for medical reasons after 1935 despite their efficacy. Safe plastic IUDs which appeared beginning in the early 1960s

  2. Depo-Provera: an injectable contraceptive.

    PubMed

    Wigington, S

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

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

    PubMed

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

    2015-01-01

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

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

    PubMed

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

    2015-05-01

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

  5. Does contraceptive use always reduce breast-feeding?

    PubMed

    Jayachandran, Seema

    2014-06-01

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

  6. Contraception and irregular menses.

    PubMed

    Hopayian, K; Houston, A; Cooke, I

    1989-03-22

    A fictitious patient with obesity, hirsutism and polycystic ovary syndrome is discussed by 3 British general practitioners to illuminate management of this type of case. The patient is 24 years old, expects to marry next year, has irregular menses averaging 6 weeks apart, and is requesting an explanation for her irregular periods as well as oral contraception. The 1st physician would exclude hypothyroidism, then evaluate polycystic ovary syndrome by assaying testosterone, LH, FSH and prolactin, next find out the significance of the patient's questions in her mind and finally prescribe a triphasic pill. The 2nd doctor would withhold the pill on the grounds that it might compromise future fertility if she has a primary endocrine imbalance. She would check rubella status, assay progesterone, LH, FSH, prolactin and testosterone on Day 19 of the cycle, and probably prescribe Marvelon oral contraceptives. The 3rd doctor would use a hirsutism score, investigate the polycystic ovary syndrome by ultrasound and an essay of sex hormone binding globulin and the LH:FSH and prolactin, next find out the significance of the patient's questions in her mind and finally prescribe a triphasic pill. The 2nd doctor would withhold the pill on the ground that it might compromise future fertility if she has a primary endocrine imbalance. She would check rubella status, assay progesterone, LH, FSH, prolactin and testosterone on Day 19 of the cycle, and probably prescribe Marvelon oral contraceptives. The 3rd doctor would use a hirsutism score, investigate the polycystic ovary syndrome by ultrasound and an assay of sex hormone binding globulin and the LH:FSH ration between Days 2-6 of the cycle, and rule out congenital adrenal hyperplasia with an assay for 17-alpha-OH-progesterone. Since the patient might be anovulatory because of obesity, major long-term weight lose is a priority. Prescription of pills would depend on family history, smoking, and the degree of hirsutism and endocrine status

  7. [PROFAMILIA studies the effectiveness of contraceptive marketing programs in Colombia].

    PubMed

    1987-01-01

    A recent study by PROFAMILIA, the private Colombian family planning organization, indicates that community based distribution programs and social marketing programs are not totally interchangeable forms of contraceptive distribution. Comparison of the efficacy of different systems in making contraceptives more accessible to the low income population led the researchers to conclude that social marketing programs work as well as community based distribution programs in rural areas which already have high rates of contraceptive usage. Community based distribution programs appear more effective than social marketing programs in areas where contraceptive usage is not yet well established. PROFAMILIA researchers conducted operational studies in 3 different states, each of which had a community based distribution program. In the first state the community based distribution program was suspended and a vender who had previously supplied only urban outlets added rural pharmacies to his route. The vender handled 3 kinds of pills, 2 types of spermicidal suppositories, and condoms. In a neighboring state, 3 instructors belonging to the community based distribution program were offered commissions of about 10% of the value of the products if the distributors they supervised met monthly sales quotas. The community based distribution program was left unchanged in the third state but a 2-member mobile team was trained to travel through the region by jeep, talking to community groups about the advantage of contraception. At the end of 18 months, sales of contraceptives had declined in the state where the community based distribution program was replaced by the social marketing program. The decline was believed to be related to unforeseen price increases for pills and devaluation of the Colombian peso. The social marketing project was however much more cost effective than the other 2, which continued to require PROFAMILIA subsidies. Contraceptive usage increased in the other 2 areas

  8. [Pregnancy contraception (Current Care Guideline)].

    PubMed

    Halttunen-Nieminen, Mervi; Piltonen, Terhi; Alenius, Heidi; Apukka, Laura; Kosunen, Elise; Pietilä, Kirsi; Sihvo, Sinikka; Vuorela, Piia; Väänänen, Eija; Yli-Kivistö, Tiina

    2016-01-01

    There are no age limits for the start or use of contraception. Prior gynecological examination or cervical smear is not needed. Condom is the only method that protects from sexually transmitted diseases. An increase in the risk of venous thromboembolism (VTE) is associated only with combined contraceptives. However, the risk is remarkably higher with pregnancy, puerperium or with smoking. The most effective reversible methods are intrauterine devices (IUD) and implants, as these do not depend on daily memory. Natural family planning methods are not reliable, and effective contraception should be easily available for all at all times. PMID:27382829

  9. New contraceptive choices across reproductive life.

    PubMed

    Foran, Therese M

    2003-06-16

    The range of contraceptive options and consumer awareness of new contraceptive methods have both increased significantly over the past 10 years. New methods available in Australia include lower-dose oral contraceptive pills, new oral progestogens, progestogen implants, a progestogen-bearing intrauterine device and polyurethane female condoms. Contraceptive options which may soon be introduced in Australia include novel methods of administering combined (oestrogen-progestogen) contraception, such as dermal patches and vaginal rings.

  10. Emergency contraception: Focus on the facts.

    PubMed

    Najera, Deanna Bridge

    2016-01-01

    Significant progress on contraception, and in particular emergency contraception, has been made in the past decade. Emergency contraception was first introduced as a stand-alone prescription in 1998, and the interaction of politics and medicine meant a tumultuous course to the drug becoming available over the counter. This article reviews how emergency contraception works, the effectiveness of different methods, pros and cons, and the history of emergency contraception. PMID:26656383

  11. [FIRST CONSULTATION IN TEENAGERS FOR CONTRACEPTION PRESCRIPTION].

    PubMed

    Béliard, A

    2016-01-01

    Adequate contraception prescription is mandatory for teenagers to avoid any unwanted pregnancy. Counselling and description of side effect improve compliance. Use of condom is important to avoid sexually transmitted infections. Combined estroprogestin contraception has multiple non-contraceptive benefits, e.g. dysmenorrhea improvement. Familial and personal history is needed before contraception prescription. Further consultation 3 months later has to be planned to evaluate compliance, side effects and to adapt contraception if needed.

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    2014-01-01

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

  14. [Disease and contraception. Recent aspects].

    PubMed

    Rozenbaum, H

    1985-01-01

    This article reviews several different articles which have contributed to an understanding of the harmful or beneficial effects of oral contraceptives (OCs) on various diseases. The Royal College of General Practitioners study found that current OC users compared to women who had never used OCs had relative risks of .52 for menorrhagia, .37 for dysmenorrhea, .65 for irregular cycles, .72 for intermenstrual bleeding, and .71 for premenstrual syndrome. Several studies found combined OCs to offer protection against ovarian cysts. Microdose progestin only pills did not ameliorate most menstrual problems and aggravated ovarian cysts. Despite some theoretical grounds for suspecting an association between pituitary prolactinomas and OC use, recent studies have failed to find an increased relative risk for prolactinomas in women using OCs for contraceptive purposes, although 1 study found an increased risk in women using OCs for cycle control. 1 study reported 11 pregnancies in 30 diabetic women in 15 months of IUD use; the high rate was attributed to abnormal patterns of mineral deposit on the IUD surface. The 11 pregnancies occurred with 5 Gravigardes, 5 Saf-T-Coils, and 1 Dalkon Shield. Other studies on the contrary have noted no difference in pregnancy rates among 103 diabetic women using Copper Ts or 118 diabetic women using Lippes loops. Combined OCs appear to reduce the incidence of rheumatoid arthritis by 1/2 among current OC users and to protect former users as well. Combined OCs aggravate lupus erythmatous but synthetic progestins alone are effective without aggravating the condition. It has recently been argued that low dose OCs are not contraindicated in cases of sickle cell disease and may even offer protection against thromboembolic vascular accidents for women with sickle cell anemia. Estimates of relative risk of pelvic infection among IUD users vary from 1.5 to 6.5, with the risk apparently greatest for women under 25. Recent studies have indicated that

  15. Tunisia: rural contraceptive distribution project has impact.

    PubMed

    1979-10-01

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

  16. The social marketing of contraceptives in Mexico.

    PubMed

    De La Macorra, L

    1980-07-01

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

  17. Emerging Options for Emergency Contraception

    PubMed Central

    Koyama, Atsuko; Hagopian, Laura; Linden, Judith

    2013-01-01

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

  18. How Effective Is Male Contraception?

    MedlinePlus

    ... Trials Resources and Publications How effective is male contraception? Skip sharing on social media links Share this: ... health care providers to determine which method of birth control is best for them. For men, methods of ...

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

    PubMed Central

    Chun, Sail; Min, Won-Ki

    2014-01-01

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

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

    ERIC Educational Resources Information Center

    Gotlib, Ian H.; And Others

    1989-01-01

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

  1. Effect of contraceptives on the skin.

    PubMed

    1988-10-01

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

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

    PubMed Central

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

    2012-01-01

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

  3. Monitoring and Prevalence Rates of Metabolic Syndrome in Military Veterans with Serious Mental Illness

    PubMed Central

    Khatana, Sameed Ahmed M.; Kane, Joshua; Taveira, Tracey H.; Bauer, Mark S.; Wu, Wen-Chih

    2011-01-01

    Background Cardiovascular disease is the leading cause of mortality among patients with serious mental illness (SMI) and the prevalence of metabolic syndrome—a constellation of cardiovascular risk factors—is significantly higher in these patients than in the general population. Metabolic monitoring among patients using second generation antipsychotics (SGAs)—a risk factor for metabolic syndrome—has been shown to be inadequate despite the release of several guidelines. However, patients with SMI have several factors independent of medication use that predispose them to a higher prevalence of metabolic syndrome. Our study therefore examines monitoring and prevalence of metabolic syndrome in patients with SMI, including those not using SGAs. Methods and Findings We retrospectively identified all patients treated at a Veterans Affairs Medical Center with diagnoses of schizophrenia, schizoaffective disorder or bipolar disorder during 2005–2006 and obtained demographic and clinical data. Incomplete monitoring of metabolic syndrome was defined as being unable to determine the status of at least one of the syndrome components. Of the 1,401 patients included (bipolar disorder: 822; schizophrenia: 222; and schizoaffective disorder: 357), 21.4% were incompletely monitored. Only 54.8% of patients who were not prescribed SGAs and did not have previous diagnoses of hypertension or hypercholesterolemia were monitored for all metabolic syndrome components compared to 92.4% of patients who had all three of these characteristics. Among patients monitored for metabolic syndrome completely, age-adjusted prevalence of the syndrome was 48.4%, with no significant difference between the three psychiatric groups. Conclusions Only one half of patients with SMI not using SGAs or previously diagnosed with hypertension and hypercholesterolemia were completely monitored for metabolic syndrome components compared to greater than 90% of those with these characteristics. With the high

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

    PubMed Central

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

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

    2008-01-01

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

  6. 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.

  7. The influence of partnership on contraceptive use among HIV-infected women accessing antiretroviral therapy in rural Uganda

    PubMed Central

    Nieves, Christina I.; Kaida, Angela; Seage, George R.; Kabakyenga, Jerome; Muyindike, Winnie; Boum, Yap; Mocello, A. Rain; Martin, Jeffrey N.; Hunt, Peter W.; Haberer, Jessica E.; Bangsberg, David R.; Matthews, Lynn T

    2016-01-01

    Objective To determine individual and dyadic factors associated with effective contraceptive use among HIV-infected women accessing antiretroviral therapy (ART) in rural Uganda. Study Design HIV-infected women enrolled in the Uganda AIDS Rural Treatment Outcomes cohort completed questionnaires (detailing socio-behavioral characteristics, sexual and reproductive history, contraceptive use, fertility desires), and phlebotomy (October 2011–March 2013). We describe prevalence of effective contraceptive use (i.e., consistent condom use, and/or oral contraceptives, injectable hormonal contraception, intrauterine device, female sterilization) in the previous six months among sexually active, non-pregnant women (18–40 years). We assessed covariates of contraceptive use using multivariable logistic regression. Results 362 women (median values: age 30 years, CD4 count 397 cells/mm3, 4.0 years since ART initiation) were included. Among 284 sexually active women, 50% did not desire a(nother) child and 51% had a sero-concordant partner. 45% (n=127) reported effective contraceptive use of whom, 57% (n=72) used condoms, 42% (n=53) injectables, 12% (n=15) oral contraceptives, and 11% (n=14) other effective methods. Dual contraception was reported by 6% (n=8). Only ‘partnership fertility desire’ was independently associated with contraceptive use; women who reported neither partner desired a child had significantly increased odds of contraceptive use (aOR: 2.40, 95% CI: 1.07–5.35) compared with women in partnerships where at least one partner desired a child. Conclusions Less than half of sexually active HIV-infected women accessing ART used effective contraception, of which 44% (n=56) relied exclusively on male condoms, highlighting a continued need to expand access to a wider range of longer acting female-controlled contraceptive methods. Association with partnership fertility desire underscores the need to include men in reproductive health programming. PMID:25983013

  8. Trends of contraception among ladies of local population in Pakistan; why, how, when and what?

    PubMed Central

    Atif, Khaula; Afsheen, Afeera; Naqvi, Syed Abid Hassan; Niazi, Saleem Asif; Ullah Khan, Habib

    2016-01-01

    Objective: To analyze trends of use of methods of contraception along with study of impact of various demographic and social factors on contraception in Peshawar, Pakistan. Methods: A cross-sectional descriptive study with random purposive sampling was conducted at Combined Military Hospital Peshawar, from Mar 2015-Nov 2015. Self-designed questionnaire with demographic details and questions pertinent to contraceptive practices was utilized as study instrument. Females reporting to concerned hospital for contraceptive advice and prescription were distributed with questionnaire and written informed consent form. Formal approval was taken from ethical committee of hospital. Data was analyzed via descriptive analysis (SPSS-21), qualitative data was expressed as frequencies and percentages; quantitative as mean±standard deviation (SD). Main outcome variable i-e contraceptive device used; was cross-tabulated with independent variables. Results: Response rate was 53.2% (n-426). Usage of contraceptive device was as follows; 51.2% Nil, 9.4% barriers, 22.3% oral/injectable hormones, 13.4% IUCDs, 3.8% sterilization. There was a strong relationship between type of contraceptives used and age (p<0.001), client’s education (p<0.001), husband’s education (p<0.001), number of children (p<0.001), religion (p0.013), socioeconomic class (p<0.001), and religious beliefs about use of contraceptives (p<0.001). More Muslims considered contraception irreligious than non-Muslims (p 0.02). There was no significant impact of husbands’ pressure to not to use contraceptives on type of contraception practised (p 0.114). Conclusion: Contraceptive devices are under-utilized in the study participants. Multidisciplinary approach should be applied to enhance client education, awareness and counseling to utilize these devices more appropriately and regularly. PMID:27375727

  9. Impact of Contraceptive Education on Contraceptive Knowledge and Decision Making

    PubMed Central

    Pazol, Karen; Zapata, Lauren B.; Tregear, Stephen J.; Mautone-Smith, Nancy; Gavin, Loretta E.

    2015-01-01

    Context Educational interventions can help increase knowledge of available contraceptive methods, enabling individuals to make informed decisions and use contraception more effectively. This systematic review evaluated contraceptive education interventions to guide national recommendations on quality family planning services. Evidence acquisition Three databases (CINAHL, PubMed, and PsycINFO) were searched from 1985 through 2012 for peer-reviewed articles on educational interventions, with supplemental searches conducted through 2015. Primary outcomes were knowledge, participation in and comfort with decision making, and attitudes toward contraception. Secondary outcomes included contraceptive use behaviors and unintended pregnancy. Evidence synthesis Database searches in 2011 identified 5,830 articles; 17 met inclusion criteria and were abstracted into evidence tables. Searches in 2012 and 2015 identified four additional studies. Studies used a wide range of tools (decision aids, written materials, audio/videotapes, and interactive games), with and without input from a healthcare provider or educator. Of 15 studies that examined the impact of educational interventions on knowledge, 14 found significant improvement using a range of tools, with and without input from a healthcare provider or educator. Fewer studies evaluated outcomes related to decision making, attitudes toward contraception, contraceptive use behaviors, or unintended pregnancy. Conclusions Results from this systematic review are consistent with evidence from the broader healthcare field suggesting that a range of educational interventions can increase knowledge. Future studies should assess what aspects of educational interventions are most effective, the extent to which it is necessary to include a healthcare provider or educator, and the extent to which educational interventions can impact behaviors. PMID:26190846

  10. 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

  11. Emergency contraception use and non-use in young women: the application of a contextual and dynamic model.

    PubMed

    Free, Caroline; Ogden, Jane

    2005-05-01

    There have been many approaches to understanding contraception use including social cognition models which have been criticised for their individualistic approach and their static nature. The present quantitative study developed and refined a contextual and dynamic model of contraception use that was derived using qualitative research. This model conceptualizes the predictors of contraception use in terms of the meaning and importance of a range of social goals, perceptions of vulnerability, and constraints on or facilitators of contraception use each of which changes over time. The present study operationalized this model in relation to emergency contraception and explored differences between users and non-users and between episodes of use and non-use. In terms of users and non-users, the results showed that the users of emergency contraception showed a more positive view of an emergency contraception user, perceived greater support from their partner for emergency contraception use, rated themselves more at risk of pregnancy, and felt more confident about asking for emergency contraception. In terms of use and non-use, use was related to an increased belief about the risk of pregnancy, increased partner support, increased concern about health care professionals and the side-effects of the drug, and a more positive identity of an emergency contraception. The study has helped to develop and refine the model and has identified some key factors that are specifically relevant to emergency contraception use in a sample of women in education in and around London.

  12. Prevalence rates of health and welfare conditions in broiler chickens change with weather in a temperate climate

    PubMed Central

    Edwards, Phil; Hajat, Shakoor

    2016-01-01

    Climate change impact assessment and adaptation research in agriculture has focused primarily on crop production, with less known about the potential impacts on livestock. We investigated how the prevalence of health and welfare conditions in broiler (meat) chickens changes with weather (temperature, rainfall, air frost) in a temperate climate. Cases of 16 conditions were recorded at approved slaughterhouses in Great Britain. National prevalence rates and distribution mapping were based on data from more than 2.4 billion individuals, collected between January 2011 and December 2013. Analysis of temporal distribution and associations with national weather were based on monthly data from more than 6.8 billion individuals, collected between January 2003 and December 2013. Ascites, bruising/fractures, hepatitis and abnormal colour/fever were most common, at annual average rates of 29.95, 28.00, 23.76 and 22.29 per 10 000, respectively. Ascites and abnormal colour/fever demonstrated clear annual cycles, with higher rates in winter than in summer. Ascites prevalence correlated strongly with maximum temperature at 0 and −1 month lags. Abnormal colour/fever correlated strongly with temperature at 0 lag. Maximum temperatures of approximately 8°C and approximately 19°C marked the turning points of curve in a U-shaped relationship with mortality during transportation and lairage. Future climate change research on broilers should focus on preslaughter mortality. PMID:27703686

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

    PubMed

    Fortier, L

    1976-09-01

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

  14. Role of the levonorgestrel intrauterine system in effective contraception

    PubMed Central

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

    2013-01-01

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

  15. HIV testing rates, prevalence, and knowledge among outpatients in Durban, South Africa: Time trends over four years.

    PubMed

    Ramirez-Avila, Lynn; Regan, Susan; Chetty, Senica; Giddy, Janet; Ross, Douglas; Katz, Jeffrey N; Freedberg, Kenneth A; Losina, Elena; Walensky, Rochelle P; Bassett, Ingrid V

    2015-09-01

    The HIV public health messages in South Africa have increased. Our objective was to evaluate changes over time in HIV testing behaviour, prevalence and knowledge. We prospectively enrolled adults (≥18 years) prior to HIV testing at one urban and one peri-urban outpatient department in Durban, South Africa. A baseline questionnaire administered before testing included the number of prior HIV tests and four knowledge items. We used test results to estimate previously undiagnosed HIV prevalence among those tested. We assessed linear trends over enrollment. From November 2006 to August 2010, 5229 subjects enrolled and 4877 (93%) were HIV tested and had results available. Subjects reporting prior testing over time increased, from 13% in study year 1 to 42% in year 4 (linear trend p < 0.001). The HIV prevalence among those tested declined steadily and significantly over time, from 64% of enrollees in study year 1 to 39% in the final year (linear trend p < 0.001). The percentage of subjects who recognised that medicine can help people with HIV live longer increased from 80% in study year 1 to 96% in study year 4. Rates of HIV testing have increased and prevalence among those tested has decreased in outpatients in Durban, South Africa.

  16. HIV Testing Rates, Prevalence, and Knowledge Among Outpatients in Durban, South Africa: Time Trends over Four Years

    PubMed Central

    RAMIREZ-AVILA, Lynn; REGAN, Susan; CHETTY, Senica; GIDDY, Janet; ROSS, Douglas; KATZ, Jeffrey N.; FREEDBERG, Kenneth A.; LOSINA, Elena; WALENSKY, Rochelle P.; BASSETT, Ingrid V.

    2014-01-01

    The HIV public health messages in South Africa have increased. Our objective was to evaluate changes over time in HIV testing behavior, prevalence, and knowledge. We prospectively enrolled adults (≥18 years) prior to HIV testing at one urban and one peri-urban outpatient department in Durban, South Africa. A baseline questionnaire administered before testing included the number of prior HIV tests and four knowledge items. We used test results to estimate previously undiagnosed HIV prevalence among those tested. We assessed linear trends over enrollment. From November 2006–August 2010, 5,229 subjects enrolled and 4,877 (93%) were HIV tested and had results available. Subjects reporting prior testing over time increased, from 13% in study year 1 to 42% in year 4 (linear trend p<0.001). The HIV prevalence among those tested declined steadily and significantly over time, from 64% of enrollees in study year 1 to 39% in the final year (linear trend p<0.001). The percentage of subjects who recognized that medicine can help people with HIV live longer increased from 80% in study year 1 to 96% in study year 4. Rates of HIV testing have increased and prevalence among those tested has decreased in outpatients in Durban, South Africa. PMID:25228664

  17. Recent advances in contraception.

    PubMed

    Erkkola, R

    2006-08-01

    The world population is expected to increase by 2.6 billion to 9.1 billion in 2050. This will occur, if fertility decreases from today's 2.6 children to about 2 children per woman. If fertility were to remain at the present level, 34 million persons would be added annually by mid-century and thus the world population would reach 10.6 billion by 2050. The most notable increase in the world population will occur in third world countries. Therefore immense investments are being made to develop safe, reliable and easily used contraceptive methods. It has not proven easy. Further, acceptance of the methods has been called into question. And even their distribution would be very difficult although Population Council and organizations like it have put a lot of effort into that matter also. In addition, the methods should preferably be such that they could to some extent prevent the rapid spread of sexually transmitted infections. So, the task is not easy, but every effort must be made on this question also at governmental and international political levels. It is noteworthy that this kind of approach has been given more currency since the beginning of this millennium.

  18. 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

  19. 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

  20. Myths and fallacies about male contraceptive methods: a qualitative study amongst married youth in slums of Karachi, Pakistan.

    PubMed

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

    2013-03-01

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

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

    ERIC Educational Resources Information Center

    Taylor, Mary E.; And Others

    1989-01-01

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

  2. 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

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

    PubMed

    Schuklenk, Udo; Kleinsmidt, Anita

    2007-07-01

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

  4. The future of oral contraceptives: research priorities.

    PubMed

    Spitzer, W O

    1996-04-01

    The author believes that currently-marketed oral contraceptives are among the most safe and effective methods of fertility control. The data on oral contraceptives and myocardial infarction are consistent with a protective, death-sparing role for third-generation oral contraceptives. Moreover, the benefit-risk profile of second-generation pills is evaluated and approved by national and international regulatory bodies. Researchers, however, should still keep working to try to provide women with the best possible contraceptive methods. Specifically, the search for safer oral contraceptives should continue, clinical research should address unanswered questions about better oral contraceptive fits for women with distinctive clinical requirements, more research is needed into the benefits of oral contraceptive use, epidemiologists and biostatisticians must develop and improve methods which permit disentangling the effect from bias in observational research, and World Health Organization and Transnational European Project data on oral contraceptives and myocardial infarction need to be meta-analyzed.

  5. Contraception in women with special medical needs.

    PubMed

    Neinstein, L

    1998-05-01

    Over 10% of women of reproductive age have experienced a serious chronic physical disorder. Reproductive health issues including contraception are frequently ignored in these individuals. Clinicians should have available current knowledge regarding interactions between contraception and these conditions. PMID:9626481

  6. How does relaxing the algorithm for autism affect DSM-V prevalence rates?

    PubMed

    Matson, Johnny L; Hattier, Megan A; Williams, Lindsey W

    2012-08-01

    Although it is still unclear what causes autism spectrum disorders (ASDs), over time researchers and clinicians have become more precise with detecting and diagnosing ASD. Many diagnoses, however, are based on the criteria established within the Diagnostic and Statistical Manual of Mental Disorders (DSM); thus, any change in these diagnostic criteria can have a great effect upon children with ASD and their families. It is predicted that the prevalence of ASD diagnoses will dramatically decrease with the adoption of the proposed DSM-5 criteria in 2013. The aim of this current study was to inspect the changes in prevalence first using a diagnostic criteria set which was modified slightly from the DSM-5 criteria (Modified-1 criteria) and again using a set of criteria which was relaxed even a bit more (Modified-2 criteria). Modified-1 resulted in 33.77 % fewer toddlers being diagnosed with ASD compared to the DSM-IV, while Modified-2 resulted in only a 17.98 % decrease in ASD diagnoses. Children diagnosed with the DSM-5 criteria exhibited the greatest levels of autism symptomatology, but the Mod-1, Mod-2, and DSM-IV groups still demonstrated significant impairments. Implications of these findings are discussed.

  7. Pulmonary embolus, oral contraceptives, and a clinical search.

    PubMed

    Maharry, J M

    1970-01-01

    At the Presbyterian Intercommunity Hospital, Whittier, California, 120 cases of pulmonary emboli occurred from 1959 through 1968. During this time there were 124,000 admissions and more than 20,000 live births. 51 of the pulmonary embolic cases were female; 25 were of childbearing age. 10 of these showed relationship to the use of oral contraceptives. 6 of them received oral contraceptives after pulmonary embolism without apparent aggravation or recurrence of thromboembolic disease. 2 of the 10 were taking birth control pills at the time they underwent hysterectomy. A pulmonary embolus followed each operation. 2 more were taking the pills and experienced pulmonary embolism without evidence of any predisposing cause. Short case summaries of the 10 are given, all of whom are living and well. Improvement of diagnosis by lung scanning shows that pulmonary embolism is more prevalent and less serious than previously believed. As thrombotic disease is considered a recurring disorder, its relationship to steroid contraceptives has not been totally substantiated. It is concluded that a history of such disease does not necessarily contraindicate the use of oral contraceptives. Following discussion, the author quotes an FDA claim that women who take birth control pills develop thrombo-phlebitis 3 times as frequently as women who do not. He notes that, even according to these Food and Drug Administration statistics, a woman could take the pills for 30 years without as much danger from thrombo-phlebitis as from a single pregnancy.

  8. Community-based contraceptive distribution: a Korean success story.

    PubMed

    Robey, B

    1987-12-01

    The results of a community-based contraceptive distribution program using village women canvassers in Cheju Island province, Korea, are evaluated. This rural province had the highest fertility and lowest contraceptive use before the project began. After pre-testing in another area, township-level family planning field workers recruited 365 new female canvassers per 150 women at risk of pregnancy, compared to 10,000-25,000 per worker in the previous scheme. The canvassers were to contact every household, offering them pills or condoms, or vouchers for an IUD or sterilization from the clinic. The former target system, which in reality had limited the numbers of acceptors, was suspended, necessitating an increase in budget outlays for family planning in Cheju province. By 1985 the contraceptive prevalence had doubled, and fertility fell 40.1 and 32.4% in the 2 Cheju counties. Costs per couple-year for the Cheju program were lower than those in other areas. The results of this project suggested that increasing the number of community workers or canvassers in rural areas helps reduce barriers to the use of contraceptives.

  9. Oral contraceptives and breast cancer: a national study.

    PubMed Central

    Paul, C; Skegg, D C; Spears, G F; Kaldor, J M

    1986-01-01

    In a population based case-control study 433 New Zealand women aged 25-54 with newly diagnosed breast cancer were compared with 897 women selected at random from the electoral rolls. The relative risk of breast cancer in women who had ever used oral contraceptives was 0.94 (95% confidence interval 0.70 to 1.25). The relative risk in women aged 25-34 at diagnosis was estimated to be 2.2 (95% confidence interval 0.47 to 9.9) and in older women less than 1. Analyses of risk by duration of use of oral contraceptives, age at first use, and time since first use showed no adverse effect of the pill. In particular, there was no increased risk in women who had used oral contraceptives before the age of 25 or before their first pregnancy, even for prolonged periods. Given the high prevalence of use in New Zealand, this study provides strong evidence against the hypothesis that use of oral contraceptives at young ages increases the risk of breast cancer. PMID:3094626

  10. Contraceptive use before and after marriage in Shanghai.

    PubMed

    Che, Yan; Cleland, John

    2003-03-01

    Data from a cohort study of 7,336 newly married fertile couples conducted between 1987 and 1995 were used to analyze contraceptive method choice, switching, and discontinuation in two districts of Shanghai. Twelve percent of couples reported that they had had sexual intercourse before marriage. Only one-third of those exposed to premarital risk of conception were protected by some form of contraception, mostly by withdrawal and periodic abstinence. As a consequence, a majority of these couples conceived, prompting rapid marriage in most cases and induced abortion among one-fourth of them. After marriage, about half of the couples used contraceptives to postpone the birth of their first child, but of these, 40 percent experienced an unintended pregnancy. Method choice was dominated by condoms, withdrawal, and abstinence. After the birth of their first child, almost all couples (98 percent) adopted contraceptives, but one-third of them used ineffective methods. Failure and discontinuation rates were high, giving rise to a high incidence of induced abortion. Increasing numbers of couples switched to the IUD, and this was the preferred method for the majority by the third year following childbirth. These results suggest that wider method choice that includes hormonal contraceptives should be provided to meet couples' needs in Shanghai and that the family planning program's attention should be focused specifically on sexually active unmarried individuals and on the availability of postpartum services.

  11. Developments in male contraception.

    PubMed

    Bialy, G; Alexander, N J

    1992-01-01

    Relevant research efforts in male contraception involve: 1) hormonal approaches to block sperm production by inhibiting the hypothalamic-pituitary-gonadal axis, 2) disruption of sperm production by drugs that act directly on the testes, 3) interruption of sperm transport, and 4) alteration of secretions of the accessory sex glands and their subsequent effect on the spermatozoa. Both agonistic and antagonistic synthetic analogs of the hypothalamic gonadotropin releasing hormone (GnRH) factor cost too much and lack an effective mode of administration. Recent studies indicate that over 90% of Chinese and Indonesian men can develop complete azoospermia following either a testosterone or a progestin and an androgen combination treatment. Vaccines that utilize GnRH and follicle stimulating hormone as the active antigens have been introduced in clinical studies in the US and India. Drugs such as sulfasalazine, pyrimethamine, nitrofurane, and bis(di-chloracytal) diamines reduce male fertility but side effects make them unacceptable. Dinitropyrroles, halopropanedils, chlorosugars, and indazole carboxylic acids have been tried in laboratory animals. Gossypol rendered men infertile in large-scale clinical studies conducted in China but synthesis of safer analogs has not succeeded. Extracts of another plant, tripterigium wilfordii, are used in China as a popular herbal medicine. Vasectomy has improved with no-scalpel vasectomy and by the novel technique of blocking the vas with cured in situ polymeric plugs. Preliminary data suggest that men prefer condoms made from polyurethane as opposed to latex rubber increasingly used to protect against AIDs and sexually transmitted diseases. The antifungal agents, imidazoles, have spermicidal activity and synthetic variants may reduce undesirable side effects. Research on male-oriented methods has intensified during the last 10-15 years, but a new product is not likely to appear in the next 5-10 years.

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

    PubMed

    Borges, Ana Luiza Vilela

    2016-02-01

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

  13. 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.

  14. HIV infection and contraceptive need among female Ethiopian voluntary HIV counseling and testing clients.

    PubMed

    Bradley, H; Tsui, A; Kidanu, A; Gillespie, D

    2010-10-01

    Despite political endorsement of voluntary HIV counseling and testing (VCT), and family planning integration in Ethiopia, little is known about the reproductive health needs of VCT clients. We estimated contraceptive prevalence and need among 646 Ethiopian female VCT clients. We compared socio-demographic characteristics of contracepting VCT clients to those with unmet need and examined how these characteristics are associated with having unmet contraceptive need and being HIV-positive using multinomial logistic regression. We also assessed the quality of VCT services from clients' reports of reproductive health topics discussed in VCT sessions. Nearly 34% of female VCT clients have unmet contraceptive need. Three socio-demographic characteristics are consistently associated with both risk for unintended pregnancy and HIV: older age, marriage, and lower education. In the multivariate analysis, older age, marriage, and belonging to a minority ethnic group are significantly associated with being both HIV-positive and having unmet contraceptive need. Conversely, higher education, larger families, and frequent sexual activity are associated with reduced likelihood of experiencing these two adverse health outcomes. VCT clients report infrequent reproductive health counseling, although HIV-positive women are more likely than HIV-negative women to have discussions about contraception with VCT counselors. At the time of this study, family planning was not offered as part of VCT programs, although VCT clients demonstrate considerable need for contraceptive services. PMID:20665282

  15. Contraception and Mental Health: A Commentary on the Evidence and Principles for Practice

    PubMed Central

    Steinberg, Julia R.; Cwiak, Carrie A.; Allen, Rebecca H.; Marcus, Sheila M.

    2014-01-01

    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 wish to avoid an unintended pregnancy, effective contraception can be an important strategy to maintain and even improve health and wellbeing. 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 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

  16. Contraceptive services for adolescents in Latin America: facts, problems and perspectives.

    PubMed

    Pons, J E

    1999-12-01

    This review presents facts about sexual and contraceptive behavior of Latin American adolescents, analyzes barriers to contraception, and summarizes present perspectives. Between 13 and 30% of Latin American adolescent women live in union before their 20th birthday and between 46 and 63% have had sexual relations. The prevalence of contraceptive use among adolescents at risk of pregnancy remains very low. The pill is the best known contraceptive method. When sexual activity becomes a permanent practice, contraceptive use increases but remains low. Barriers to contraception can be identified as: (1) arising from adolescents themselves (moral objections, alleged medical reasons, lack of confidence in adults and in the health system, promiscuity; (2) arising from the sexual partner (partner's opposition, masculine irresponsibility); (3) arising from adults (moral objections, fear of sex education, adult control and power of decision-making); (4) arising from the health system (inappropriateness of services, regulatory barriers, gender inequality); (5) arising from health professionals (medical barriers to contraceptive use, discomfort with sexual matters); (6) arising from the educational system (educational failure, teachers' reluctance); and (7) arising from other social agents (religious opposition, media ambivalent messages, fund restraints). There have been improvements in recent years, including the achievements of groups working for and with adolescents, and the support from distinguished personalities.

  17. 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.

  18. Injectable contraceptives: how safe are they?

    PubMed

    1979-01-01

    Controversy still surrounds the use of the injectable contraceptive, Depo-Provera, in 3rd world countries, when it has yet to be approved in the US, Canada, Japan, and other developed nations. Some medical professionals maintain Depo is both safe and effective and could curb rapid population growth worldwide. With no conclusive decision made, some countries have approved Depo while others have not yet decided. Originally approved for a variety of uses, Depo is approved in the US only as a treatment for advanced endometrial cancer; however, it is now available in 65 countries and is used as a contraceptive in the Philippines. Depo and its companion Norigest are both progestonogenic injectables and were developed in the late 1950s. Injectables inhibit ovulation and thicken cervical mucus, thereby preventing fertilization. The reservoir usually lasts from 3-6 months, and its action cannot be reversed until the body has completely absorbed the drug. Injectables are highly effective; most accidental pregnancies occur shortly after the 1st injection before the drug has taken effect or at the end of an interval when its effect is wearing off. Overall the rate of fertility return corresponds to the rates for the pill and the IUD. Injectables have the advantage of preventing side effects brought on by estrogens; thus they would be beneficial to women desiring to use contraception but who cannot manage pill side effects. They do not interfere with lactation and have the lowest failure rate of the reversible methods. Important to developing countries is that injectables require no effort on the part of the user. Injectables do disrupt the menstrual pattern and Depo use often results in weight gain. Little is known about the longterm risks of Depo; however, in 1973 the US Food and Drug Administration withdrew approval of Depo for pregnancy-related uses because of links to birth defects. Other recent studies have uncovered other possible effects including uncertainty about

  19. Flea species infesting dogs in Florida and Bartonella spp. prevalence rates.

    PubMed

    Yore, K; DiGangi, B; Brewer, M; Balakrishnan, N; Breitschwerdt, E B; Lappin, M

    2014-01-31

    Several Bartonella spp. associated with fleas can induce a variety of clinical syndromes in both dogs and humans. However, few studies have investigated the prevalence of Bartonella in the blood of dogs and their fleas. The objectives of this study were to determine the genera of fleas infesting shelter dogs in Florida, the prevalence of Bartonella spp. within the fleas, and the prevalence of Bartonella spp. within the blood of healthy dogs from which the fleas were collected. Fleas, serum, and EDTA-anti-coagulated whole blood were collected from 80 healthy dogs, and total DNA was extracted for PCR amplification of Bartonella spp. The genera of fleas infesting 43 of the dogs were determined phenotypically. PCR amplicons from blood and flea pools were sequenced to confirm the Bartonella species. Amplicons for which sequencing revealed homology to Bartonella vinsonii subsp. berkhoffii (Bvb) underwent specific genotyping by targeting the 16S-23S intergenic spacer region. A total of 220 fleas were collected from 80 dogs and pooled by genus (43 dogs) and flea species. Bartonella spp. DNA was amplified from 14 of 80 dog blood samples (17.5%) and from 9 of 80 pooled fleas (11.3%). B. vinsonii subsp. berkhoffii DNA was amplified from nine dogs and five of the flea pools. Bartonella rochalimae (Br) DNA was amplified from six dogs and two flea pools. One of 14 dogs was co-infected with Bvb and Br. The dog was infested with Pulex spp. fleas containing Br DNA and a single Ctenocephalides felis flea. Of the Bvb bacteremic dogs, five and four were infected with genotypes II and I, respectively. Of the Bvb PCR positive flea pools, three were Bvb genotype II and two were Bvb genotype I. Amplification of Bvb DNA from Pulex spp. collected from domestic dogs, suggests that Pulex fleas may be a vector for dogs and a source for zoonotic transfer of this pathogen from dogs to people. The findings of this study provide evidence to support the hypothesis that flea-infested dogs may be a

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

    PubMed Central

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

    2014-01-01

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

  1. Relative risks of oral contraceptive usage.

    PubMed

    Kirkham, C; Reid, R L

    1987-04-01

    Women seeking safe, reliable contraception must weigh the risks associated with such methods with their benefits. To make this assessment process more meaningful, the authors have prepared a chart that sets forth the risks of oral contraceptive (OC) use by different user factors (e.g., age, cigarette smoking) in proportion to the risks inherent in a variety of sporting activities and types of accidents. Mortality rates reported for OC use include those due to the method and those due to pregnancies resulting from method failure. Scrutiny of this chart reveals that the risk of death associated with swimming, boating, and automobile use exceeds the risk of death for nonsmokers who use OCs up to 34 years of age (1.6 deaths/100,000 population). OC use by women 15-24 years of age who smoke carries a lower mortality risk (3.0/1000) than scuba diving or falling, while OC users 25-34 years old who smoke are more likely to die as a result of homicide, suicide, or automobile accidents than they are as a result of their use of OCs (mortality rate, 10.2/1000). On the other hand, OC use by smokers 35-44 years of age is associated with a mortality rate of 84.5/1000, which is a higher risk than that associated with the sport of hang-gliding.

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

    PubMed Central

    Adebowale, Ayo Stephen; Morhason-Bello, ImranOludare

    2015-01-01

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

  3. Teen Council urges improved contraceptive accessibility.

    PubMed

    1988-01-01

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

  4. 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…

  5. Diagnosis and prevalence of uterine leiomyomata in female chimpanzees (Pan troglodytes).

    PubMed

    Videan, E N; Satterfield, W C; Buchl, S; Lammey, M L

    2011-07-01

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

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

    PubMed Central

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

    2011-01-01

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

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

    PubMed

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

    2012-12-01

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

  8. Left Ventricular Diastolic Dysfunction in Dialysis Patients Assessed by Novel Speckle Tracking Strain Rate Analysis: Prevalence and Determinants

    PubMed Central

    de Bie, Mihály K.; Ajmone Marsan, Nina; Gaasbeek, André; Bax, Jeroen J.; Groeneveld, Marc; Gabreels, Bas A.; Delgado, Victoria; Rabelink, Ton J.; Schalij, Martin J.; Jukema, J. Wouter

    2012-01-01

    Background. Diastolic dysfunction is common among dialysis patients and is associated with increased morbidity and mortality. Novel echocardiographic speckle tracking strain analysis permits accurate assessment of left ventricular diastolic function, independent of loading conditions and taking all myocardial segments into account. The aim of the study was to evaluate the prevalence of diastolic dysfunction in chronic dialysis patients using this novel technique, and to identify its determinants among clinical and echocardiographic variables. Methods. Patients currently enrolled in the ICD2 study protocol were included for this analysis. Next to conventional echo measurements diastolic function was also assessed by global diastolic strain rate during isovolumic relaxation (SRIVR). Results. A total of 77 patients were included (age 67 ± 8 years, 74% male). When defined as E/SRIVR ≥236, the prevalence of diastolic dysfunction was higher compared to more conventional measurements (48% versus 39%). Left ventricular mass (OR 1.02, 95% CI 1.00–1.04, P = 0.014) and pulse wave velocity (OR 1.34, 95% CI 1.07–1.68, P = 0.01) were independent determinants of diastolic dysfunction. Conclusion. Diastolic dysfunction is highly prevalent among dialysis patients and might be underestimated using conventional measurements. Left ventricular mass and pulse wave velocity were the only determinants of diastolic dysfunction in these patients. PMID:22649726

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

    PubMed

    Daley, Alison Moriarty

    2014-01-01

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

  10. Community characteristics, leaders, fertility and contraception in Bangladesh.

    PubMed

    Rob, A K

    1988-06-01

    a religious school has a depressing impact on the contraceptive use rate. In both regions, the presence of government health clinics has a strong positive association with the contraceptive use rate. Community development programs showed an inconsistent relationship with the contraceptive use rate. PMID:12281656

  11. Prevalence rate of Metabolic Syndrome in a group of light and heavy smokers

    PubMed Central

    2013-01-01

    Background Smoking is an important cause of morbidity and mortality worldwide. It is widely accepted as a major risk factor for metabolic and cardiovascular disease. Smoking reduces insulin sensitivity or induces insulin resistance and enhances cardiovascular risk factors such as elevated plasma triglycerides, decreases high-density lipoprotein cholesterol and causes hyperglycemia. Several studies show that smoking is associated with metabolic abnormalities and increases the risk of Metabolic Syndrome. The aim of this study was to estimate the prevalence of the metabolic syndrome in a group of light and heavy smokers, wishing to give up smoking. Methods In this cross-sectional study all the enrolled subjects voluntary joined the smoking cessation program held by the Respiratory Pathophysiology Unit of San Matteo Hospital, Pavia, Northern Italy. All the subjects enrolled were former smokers from at least 10 years and had no cancer or psychiatric disorders, nor history of diabetes or CVD or coronary artery disease and were not on any medication. Results The subjects smoke 32.3 ± 16.5 mean Pack Years. The prevalence of the metabolic syndrome is 52.1%: 57.3% and 44.9% for males and females respectively. Analysing the smoking habit influence on the IDF criteria for the metabolic syndrome diagnosis we found that all the variables show an increasing trend from light to heavy smokers, except for HDL cholesterol. A statistical significant correlation among Pack Years and waist circumference (R = 0.48, p < 0.0001), Systolic Blood Pressure (R = 0.18, p < 0.05), fasting plasma glucose (R = 0.19, p < 0.005) and HDL cholesterol (R = −0.26, p = 0.0005) has been observed. Conclusions Currently smoking subjects are at high risk of developing the metabolic syndrome. Therapeutic lifestyle changes, including smoking cessation are a desirable Public health goal and should successfully be implemented in clinical practice at any age. PMID:23721527

  12. 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.

  13. The cardiovascular safety of triphasic contraceptive steroids.

    PubMed

    Shaarawy, M; Nafea, S; Abdel-Aziz, O; Rahseed, K; Sheiba, M

    1997-09-01

    It was hypothesized that estrogen-induced cardioprotection is mediated by up-regulation and down-regulation of expression of nitric oxide (NO) and P-selectin, respectively. Published data on circulating levels of the vasodilator NO, atherogenic glycoprotein P-selectin, and lipoprotein-a [Lp(a)] in users of triphasic contraceptive steroids are lacking. A total of 30 healthy women (nonusers, controls) and 82 women using oral triphasic contraceptive steroids (ethinyl estradiol and levonorgestrel: Triovlar, Schering AG) for 18 to 24 cycles participated in this study. Fasting blood samples were obtained from users and nonusers for the determination of P-selectin and Lp(a) by enzyme immunoassay and NO by a colorimetric method. The serum Lp(a) levels in OC users were significantly higher than those of nonusers. On the other hand, the serum NO levels in OC users were significantly elevated when compared to nonusers. Plasma P-selectin was significantly lowered in OC users p < 0.005. These results demonstrate the beneficial effects of ethinyl estradiol in the triphasic contraceptive regimen. Ethinyl estradiol may afford a degree of anti-atherogenic-cardioprotective effect by up-regulation of the expression of the vasodilator NO and down-regulation of the expression of the atherogenic P-selectin. This may outweigh the cardiovascular risk of the increased atherogenic Lp(a). This study may explain the very low rate of mortality from venous thromboembolism in OC users, which compares favorably with the risks that many people accept in daily life.

  14. Contraceptive Coverage and the Affordable Care Act.

    PubMed

    Tschann, Mary; Soon, Reni

    2015-12-01

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

  15. Contraceptive Coverage and the Affordable Care Act.

    PubMed

    Tschann, Mary; Soon, Reni

    2015-12-01

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

  16. Contraceptive choices among Nigerian women attending an antenatal clinic.

    PubMed

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

    1998-06-01

    The factors determining the choice of contraception were studied among 230 pregnant women attending the antenatal clinic at Nnewi, Nigeria. There were 174 (52.1%) choices for the natural methods of contraception, 86 (25.7%) for the traditional methods, and 74 (22.2%) for the artificial methods. The most commonly chosen contraceptive methods were rhythm, 95 (28.4%) and Billings, 79 (23.5%), while the least was surgical contraception, 4 (1.2%). The barrier method was not chosen at all. The most common reason given for choice of contraception was safety, 28.7%, followed by dislike of artificial methods, 25.2%; the no-response rate was 29.1%. Other reasons given were ease of use, 10%; husband's decision, 1.3%; fear of the complications of the artificial methods, 13%; dislike of foreign body, 2.6%; the method most understood, 24.8%; need for further counselling, 7%; and long-lasting, 2.6%. The most common reason given against the use of the artificial methods of contraception was fear of its complications, 31.9%, followed by preference for the natural methods, 22.3%. Condom use decreased with increasing age, being highest at 16-20 years, 37.5%, and lowest at 31-35 years, 5.9%. When compared with other parity groups, the grandmultipara group (> or = 5) used the IUD, 14.3%; injectable contraception, 4.8%; and other traditional methods (breastfeeding and abstinence), 28.5%, and did not use the rhythm method. Women of the lowest social class most commonly chose other traditional methods, 57.1%, and never chose the Billings method. Women who desired 1 to 3 children most commonly chose the pill, 23.5%, or withdrawal method, 23.5%, while women who desired 4 to 10 children most commonly chose the rhythm and Billings methods. There was no difference in choice of method of contraception for the various religious denominations, although the artificial methods were less commonly chosen by Catholics, 14.1%, compared with Anglicans, 33%, and other Christian denominations, 33.3%. The

  17. Progestin-Only Oral Contraceptives

    MedlinePlus

    ... on another day, use a backup method of birth control (such as a condom and/or a spermicide) for the next 48 hours. If you have had a miscarriage or an abortion, you can start taking progestin-only oral contraceptives ...

  18. Contraception in the prepill era.

    PubMed

    Connell, E B

    1999-01-01

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

  19. 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…

  20. FastStats: Contraceptive Use

    MedlinePlus

    ... Family Growth [PDF - 723 KB] Use of Emergency Contraception Among Women Aged 15–44: United States, 2006–2010 Related Links National Survey of Family Growth CDC Division of Reproductive Health National Institute of Child Health and Human Development Get Email Updates To receive email updates ...

  1. Emergency contraception: increasing public awareness.

    PubMed

    2003-02-01

    This article begins by addressing misperceptions that emergency contraception is something new and untested or inherently unsafe, and that it is comparable to an abortion. It then describes efforts that are underway to increase awareness among consumers and health care providers alike.

  2. Fertility after contraception or abortion.

    PubMed

    Huggins, G R; Cullins, V E

    1990-10-01

    There is a very small correlation, if any, between the prior use of OCs and congenital malformations, including Down's syndrome. There are few, if any, recent reports on masculinization of a female fetus born to a mother who took an OC containing 1 mg of a progestogen during early pregnancy. However, patients suspected of being pregnant and who are desirous of continuing that pregnancy should not continue to take OCs, nor should progestogen withdrawal pregnancy tests be used. Concern still exists regarding the occurrence of congenital abnormalities in babies born to such women. The incidence of postoperative infection after first trimester therapeutic abortion in this country is low. However, increasing numbers of women are undergoing repeated pregnancy terminations, and their risk for subsequent pelvic infections may be multiplied with each succeeding abortion. The incidence of prematurity due to cervical incompetence or surgical infertility after first trimester pregnancy terminations is not increased significantly. Asherman's syndrome may occur after septic therapeutic abortion. The pregnancy rate after treatment of this syndrome is low. The return of menses and the achievement of a pregnancy may be slightly delayed after OCs are discontinued, but the fertility rate is within the normal range by 1 year. The incidence of postpill amenorrhea of greater than 6 months' duration is probably less than 1%. The occurrence of the syndrome does not seem to be related to length of use or type of pill. Patients with prior normal menses as well as those with menstrual abnormalities before use of OCs may develop this syndrome. Patients with normal estrogen and gonadotropin levels usually respond with return of menses and ovulation when treated with clomiphene. The rate for achievement of pregnancy is much lower than that for patients with spontaneous return of menses. The criteria for defining PID or for categorizing its severity are diverse. The incidence of PID is higher

  3. 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.

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

    ERIC Educational Resources Information Center

    Kirchner, C.

    1990-01-01

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

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

    PubMed Central

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

    1989-01-01

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

  6. Coping with contraception: cognitive and behavioral methods with adolescents.

    PubMed

    Gilchrist, L D; Schinke, S P

    1983-01-01

    Teenagers' sporadic use or nonuse of contraception is 1 explanation for the high rates of unwanted pregnancies in the US. Past efforts have had limited impact as they focused on simply providing adolescents with information and increased access to birth control. The argument here points to specific cognitive and behavioral skills, which adolescents lack, and which are required for effective contraception. Previous research documents an increase in teenagers' use of contraception following a skills-training program presented in intensive small-group format. The present study evaluates cognitive and behavioral skills training methods implemented with large groups (n=120), in the natural environment. The subjects are male and female students of a middle class suburban public high school. Training in this preventive approach stresses verbal and nonverbal components of effective interpersonal communication--approach, refusal and request responses--as important behavioral skills. Cognitive skills training emphasizes the application of facts about reproduction and contraception to make optimal decisions in situations involving sexual activity. Leaders help the subjects relate abstract facts and observable risks to their own life circumstances and choices. Additional skills practice involves the completion of written assignments outside the group setting. At the end of the 2-week training period, the students are evaluated along 4 measures: a knowledge inventory, a contraceptive attitudes and intentions inventory, and a videotaped performance test. Analyses of findings support the feasibility of large-group procedures for helping adolescents cope with sexuality and contraception. Future investigations are needed to replicate the present research as are longitudinal follow-up data to assess the long-term effects of this treatment approach.

  7. Contraception in ethnic minority groups in Bedford.

    PubMed

    Beard, P

    1982-08-01

    As an aid to health visitors who must provide advice on family planning, this article discusses the cultural and religious backgrounds of Italians, West Indians, Bengalis, and Punjabis as they affect family size and family planning, and describes a survey of the contraceptive practices of 100 mothers from these groups in Bedford. Family planning advice is provided to all mothers by doctors and health visitors, and services are available at family planning clinics or through general practitioners. Most of the Italians in Bedford originated in southern Italy. Traditional family life and strict morality remain strong, and Roman Catholic attitudes toward childbearing and birth control are influential. There are trends toward greater fertility decision making by couples, however. West Indians are characterized by a high illegitimacy rate, unstable unions, and early sexual experience, but their birthrate has fallen since their initial immigration to Britain. Among Bengalis, childbearing is the only means of prestige for women and sons are regarded as a source of security. Contraceptives are approved by the Islam religion but are seen as a threat to the traditional power structure of the male-dominated family. Punjabis, at one time a peasant group, are tending to become craftsmen with better education and the nuclear family is more common. Hinduism stresses early marriage and having many sons, but among Sikhs women may work outside the home and exercise great influence in family affairs. 10 West Indian, 9 Bengali, 44 Italian, and 37 Punjabi women having babies since June 1979 were selected from the birth record books of 3 health visitors in Bedford. There was no control group, and a true comparison was not possible. Average age and parity were 24 and 1.7 for West Indians, 27 and 4.4 for Bengalis, 26 and 1.8 for Italians, and 26 and 2.3 for Punjabis. 4 of 10 West Indians were unmarried, but there were no unmarried Asian mothers and only 1 Italian. Most women went to

  8. [The history of the contraceptive sheath].

    PubMed

    Guyotjeannin, C

    1984-06-01

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

  9. Alcohol use and contraception in first sexual experiences.

    PubMed

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

    1995-02-01

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

  10. Continuation rates, bleeding profile acceptability, and satisfaction of women using an oral contraceptive pill containing estradiol valerate and dienogest versus a progestogen-only pill after switching from an ethinylestradiol-containing pill in a real-life setting: results of the CONTENT study

    PubMed Central

    Briggs, Paula; Serrani, Marco; Vogtländer, Kai; Parke, Susanne

    2016-01-01

    Background Oral contraceptives are still associated with high discontinuation rates, despite their efficacy. There is a wide choice of oral contraceptives available, and the aim of this study was to assess continuation rates, bleeding profile acceptability, and the satisfaction of women in the first year of using a contraceptive pill containing estradiol valerate and dienogest (E2V/DNG) versus a progestogen-only pill (POP) in a real-life setting after discontinuing an ethinylestradiol-containing pill. Methods and results In this prospective, noninterventional, observational study, 3,152 patients were included for the efficacy analyses (n=2,558 women in the E2V/DNG group and n=592 in the POP group (two patients fulfilled the criteria of the efficacy population, but the used product was not known). Women had been taking an ethinylestradiol-containing pill ≥3 months before deciding to switch to the E2V/DNG pill or a POP. Overall, 19.8% (n=506) of E2V/DNG users and 25.8% (n=153) of POP users discontinued their prescribed pill. The median time to discontinuation was 157.0 days and 127.5 days, respectively. Time to discontinuation due to bleeding (P<0.0001) or other reasons (P=0.022) was significantly longer in the E2V/DNG group versus the POP group. The E2V/DNG pill was also associated with shorter (48.7% vs 44.1%), lighter (54% vs 46.1%), and less painful bleeding (91.1% vs 73.7%) and greater user satisfaction (80.7% vs 64.6%) than POP use, within 3–5 months after switch. Conclusion The E2V/DNG pill was associated with higher rates of continuation, bleeding profile acceptability, and user satisfaction than POP use and may be an alternative option for women who are dissatisfied with their current pill. PMID:27695365

  11. Continuation rates, bleeding profile acceptability, and satisfaction of women using an oral contraceptive pill containing estradiol valerate and dienogest versus a progestogen-only pill after switching from an ethinylestradiol-containing pill in a real-life setting: results of the CONTENT study

    PubMed Central

    Briggs, Paula; Serrani, Marco; Vogtländer, Kai; Parke, Susanne

    2016-01-01

    Background Oral contraceptives are still associated with high discontinuation rates, despite their efficacy. There is a wide choice of oral contraceptives available, and the aim of this study was to assess continuation rates, bleeding profile acceptability, and the satisfaction of women in the first year of using a contraceptive pill containing estradiol valerate and dienogest (E2V/DNG) versus a progestogen-only pill (POP) in a real-life setting after discontinuing an ethinylestradiol-containing pill. Methods and results In this prospective, noninterventional, observational study, 3,152 patients were included for the efficacy analyses (n=2,558 women in the E2V/DNG group and n=592 in the POP group (two patients fulfilled the criteria of the efficacy population, but the used product was not known). Women had been taking an ethinylestradiol-containing pill ≥3 months before deciding to switch to the E2V/DNG pill or a POP. Overall, 19.8% (n=506) of E2V/DNG users and 25.8% (n=153) of POP users discontinued their prescribed pill. The median time to discontinuation was 157.0 days and 127.5 days, respectively. Time to discontinuation due to bleeding (P<0.0001) or other reasons (P=0.022) was significantly longer in the E2V/DNG group versus the POP group. The E2V/DNG pill was also associated with shorter (48.7% vs 44.1%), lighter (54% vs 46.1%), and less painful bleeding (91.1% vs 73.7%) and greater user satisfaction (80.7% vs 64.6%) than POP use, within 3–5 months after switch. Conclusion The E2V/DNG pill was associated with higher rates of continuation, bleeding profile acceptability, and user satisfaction than POP use and may be an alternative option for women who are dissatisfied with their current pill.

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

    PubMed

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

    2016-01-01

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

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

    PubMed

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

    2016-04-01

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

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

    PubMed Central

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

    2014-01-01

    Objective Women with inflammatory bowel diseases (IBD) utilize contraception at a lower rate than the general population. We sought to identify factors associated with contraceptive use and selection of more effective methods in IBD patients at risk for unintended pregnancy. Study Design An online survey was distributed to women with IBD in January 2013. Contraceptive methods were categorized by effectiveness and associations with use explored by demographics, disease characteristics, and reproductive goals. Results 162 respondents were analyzed: 62% had Crohn’s disease and 38% ulcerative colitis. Mean age was 31 (range 20–45), 97% identified as White, and 53% were nulliparas. 74% were currently using IBD medications. A quarter of participants (23%) used no contraception, 17% used highly effective methods, 41% used short-term hormonal methods, and 19% chose barrier/behavioral methods. Prior IBD-related surgery, biologic therapy use, and low education attainment were associated with no contraception use. Of contraceptive users, age, parity, insurance status, IBD surgery and prior immunomodulator use were associated with highly effective method selection. Conclusions A quarter of women with IBD at-risk for pregnancy in this study population reported no contraceptive method use. Higher levels of IBD activity influence contraceptive use and method selection, which could guide future patient and provider educational interventions. Implications Pregnancy planning is important for women with inflammatory bowel diseases to avoid adverse outcomes in a disease-poor state. Use of contraception assists in avoidance of unintended pregnancy. IBD characteristics are targets for educational interventions to improve uptake of highly effective contraceptive methods. PMID:24486008

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

    PubMed Central

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

    2015-01-01

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

  16. Affordable Care Act's Mandate Eliminating Contraceptive Cost Sharing Influenced Choices Of Women With Employer Coverage.

    PubMed

    Carlin, Caroline S; Fertig, Angela R; Dowd, Bryan E

    2016-09-01

    Patient cost sharing for contraceptive prescriptions was eliminated for certain insurance plans as part of the Affordable Care Act. We examined the impact of this change on women's patterns of choosing prescription contraceptive methods. Using claims data for a sample of midwestern women ages 18-46 with employer-sponsored coverage, we examined the contraceptive choices made by women in employer groups whose coverage complied with the mandate, compared to the choices of women in groups whose coverage did not comply. We found that the reduction in cost sharing was associated with a 2.3-percentage-point increase in the choice of any prescription contraceptive, relative to the 30 percent rate of choosing prescription contraceptives before the change in cost sharing. A disproportionate share of this increase came from increased selection of long-term contraception methods. Thus, the removal of cost as a barrier seems to be an important factor in contraceptive choice, and our findings about long-term methods may have implications for rates of unintended pregnancy that require further study. PMID:27605640

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

    PubMed

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

    2016-02-01

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

  18. ERICA: sexual initiation and contraception in Brazilian adolescents

    PubMed Central

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

    2016-01-01

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

  19. 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

  20. 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

  1. 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

  2. New concepts in contraception: Norplant subdermal implant.

    PubMed

    Lynn, M M; Holdcroft, C

    1992-03-01

    User compliance is not a problem for the recently approved subdermal, longterm contraceptive delivery system, Norplant. It delivers 50-80 mcg of levonorgestrel/day during the 1st year and 30-35 mcg for years 2-5. The levonorgestrel is encased in 6 36 mm x 2.4 mm capsules which are placed in the upper arm in 5-10 minutes using local anesthesia. Since the implants systemically release levonorgestrel, the shock to the liver experienced in oral contraceptive (OC) users does not occur. Levonorgestrel prevents pregnancy by decreasing luteinizing hormone and follicle stimulating hormone which prevents ovulation, reducing the rate of ovum transfer in the tube, making the endometrium incompatible for implantation, and making the cervical mucus too thick and scanty for sperms to migrate if ovulation does occur. 1-year pregnancy rates for Norplant users are much lower than for women who use other contraceptives (0.6/100 users vs. 2.3/100 for OC users and 2.4/100 for IUD users). The ectopic pregnancy rate is also low (1.47/1000 Norplant users). The 1-year continuation rate is 80% compared with 50% for OC users. Fertility returns within 3 months for 50% of users and within 1 year for 80%. Because Norplant does not adversely affect lipid metabolism there is no increase in the risk of atherogenesis. Menstrual irregularities are the leading side effect of Norplant. The irregular cycles tend to occur during the 1st 3-6 months after insertion. Other side effects include headaches, acne, breast discharge, weight gain, and transient ovarian cysts. Contraindications are abnormal uterine bleeding, possible pregnancy, active liver disease, and women taking phenytoin. The cost for the initial exam and insertion of the Norplant capsules is $500 at Planned parenthood of the Rocky Mountains in Colorado (mean=$8.30/month vs. $13/month for 5 years of taking OCs). Due to the possibility of exploitation of women and involuntary infertility, nurse practitioners must thoroughly explain the system

  3. Long term observation of MRSA prevalence in a German rehabilitation center: risk factors and variability of colonization rate

    PubMed Central

    Gieffers, Jens; Ahuja, André; Giemulla, Ronald

    2016-01-01

    Background: Data on MRSA prevalence in rehabilitation centers are sparse. Methods: We screened more than 18,000 patients with neurological, cardiac/pulmonary or orthopedic diagnoses treated in three German rehabilitation centers and documented potential risk factors in almost 1,500 of them. Results: 2.1% were MRSA positive (CI 1.9%–2.4%). Prevalence was higher in neurologic patients (3.7%) and lower in orthopedic patients (0.9%). While the overall MRSA situation was stable over two years, the weekly MRSA rate fluctuated strongly (0.0% to 8.0%). We confirmed five risk factors in our study population. A risk adapted screening strategy derived from our data had a significance of 74% and a positive predictive value of only 2.2%. Conclusion: MRSA positivity is a rare and highly variable event, requiring a huge sample size to generate robust data. The benefit of a risk-adapted screening strategy over a general screening should be questioned in each individual setting. PMID:27777874

  4. Does contraceptive treatment in wildlife result in side effects? A review of quantitative and anecdotal evidence.

    PubMed

    Gray, Meeghan E; Cameron, Elissa Z

    2010-01-01

    The efficacy of contraceptive treatments has been extensively tested, and several formulations are effective at reducing fertility in a range of species. However, these formulations should minimally impact the behavior of individuals and populations before a contraceptive is used for population manipulation, but these effects have received less attention. Potential side effects have been identified theoretically and we reviewed published studies that have investigated side effects on behavior and physiology of individuals or population-level effects, which provided mixed results. Physiological side effects were most prevalent. Most studies reported a lack of secondary effects, but were usually based on qualitative data or anecdotes. A meta-analysis on quantitative studies of side effects showed that secondary effects consistently occur across all categories and all contraceptive types. This contrasts with the qualitative studies, suggesting that anecdotal reports are insufficient to investigate secondary impacts of contraceptive treatment. We conclude that more research is needed to address fundamental questions about secondary effects of contraceptive treatment and experiments are fundamental to conclusions. In addition, researchers are missing a vital opportunity to use contraceptives as an experimental tool to test the influence of reproduction, sex and fertility on the behavior of wildlife species.

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

    PubMed

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

    2015-12-01

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

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

    PubMed

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

    2015-12-01

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

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

    PubMed Central

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

    2015-01-01

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

  8. Clopidogrel use After Myocardial Revascularization: Prevalence, Predictors, and One-Year Survival Rate

    PubMed Central

    Prates, Paulo Roberto L.; Williams, Judson B.; Mehta, Rajendra H.; Stevens, Susanna R.; Thomas, Laine; Smith, Peter K.; Newby, L. Kristin; Kalil, Renato A. K.; Alexander, John H.; Lopes, Renato D.

    2016-01-01

    Introduction Antiplatelet therapy after coronary artery bypass graft (CABG) has been used. Little is known about the predictors and efficacy of clopidogrel in this scenario. Objective Identify predictors of clopidogrel following CABG. Methods We evaluated 5404 patients who underwent CABG between 2000 and 2009 at Duke University Medical Center. We excluded patients undergoing concomitant valve surgery, those who had postoperative bleeding or death before discharge. Postoperative clopidogrel was left to the discretion of the attending physician. Adjusted risk for 1-year mortality was compared between patients receiving and not receiving clopidogrel during hospitalization after undergoing CABG. Results At hospital discharge, 931 (17.2%) patients were receiving clopidogrel. Comparing patients not receiving clopidogrel at discharge, users had more comorbidities, including hyperlipidemia, hypertension, heart failure, peripheral arterial disease and cerebrovascular disease. Patients who received aspirin during hospitalization were less likely to receive clopidogrel at discharge (P≤0.0001). Clopidogrel was associated with similar 1-year mortality compared with those who did not use clopidogrel (4.4% vs. 4.5%, P=0.72). There was, however, an interaction between the use of cardiopulmonary bypass and clopidogrel, with lower 1-year mortality in patients undergoing off-pump CABG who received clopidogrel, but not those undergoing conventional CABG (2.6% vs 5.6%, P Interaction = 0.032). Conclusion Clopidogrel was used in nearly one-fifth of patients after CABG. Its use was not associated with lower mortality after 1 year in general, but lower mortality rate in those undergoing off-pump CABG. Randomized clinical trials are needed to determine the benefit of routine use of clopidogrel in CABG. PMID:27556308

  9. Noncontraceptive use of contraceptive agents.

    PubMed

    Nickles, Monique Collier; Alderman, Elizabeth

    2014-06-01

    • On the basis of strong research evidence, there are many noncontraceptive advantages to use of hormonal contraceptive agents in adolescent girls. (3) (4)(5)(7)(10)(11)(12)(13)(14). • On the basis of research evidence and consensus, most of these agents are safe with minor adverse effects. (2)(3)(4)(5)(7)(10)(11)(12)(13)(14). • On the basis of research evidence and consensus, through application of evidence-based approaches and proper counseling, pediatricians can use various contraceptive agents to treat several medical conditions and to help alleviate many of the undesired symptoms and complications associated with menstrual periods. (2)(3)(4)(5)(7)(10)(11)(12)(13) (14). • On the basis of research evidence and consensus, these agents may be used in sexually active adolescents to simultaneously help prevent unintended adolescent pregnancies. (2)(3)(4)(5)(7)(10)(11)(12)(13)(14).

  10. [Contraception in Mauritius (Author's transl)].

    PubMed

    Elia, D

    1980-07-01

    Contraception was introduced in Mauritius in 1958 by the private Planning Association, followed in 1962 by the catholic organization Family Action, which sponsored the temperature method only. In 1972 both associations were absorbed by the government controlled Maternal Infant Protection, which allocated 8% of the national budget. Results were formidable. Almost 60% of the population (both men and women) now use contraception. 54% of women of fertile age use the pill. 9% use the temperature method. 18% use the condom. 6% of the women utilize injections of depo Provera. 3% use the IUD. Parity went from 5.2 in 1962, to 2.6 in 1979. Sexual sterilization, however, is still illegal, and so is induced abortion, with the result that there are about 20,000 illegally induced abortions every year, of which 200 generate complications leading to hospitalization.

  11. Long-acting hormonal contraception.

    PubMed

    Benagiano, Giuseppe; Gabelnick, Henry; Brosens, Ivo

    2015-11-01

    Today, a new category of fertility-regulating agents has been created: long-acting, reversible hormonal contraceptives; they minimize compliance, while maximize effectiveness. They comprise subdermal implants and intrauterine devices. Other long-acting agents exist, such as Depo Provera and Noristerat. Use of Depo Provera and Noristerat carries great effectiveness, good clinical safety and usefulness in developing countries. They cause no significant increase in breast cancer risk, but they may carry an increased risk of HIV. Subcutaneous delivery systems have two common features: prolongation of effect is obtained by a drug reservoir and for most of their duration of action they provide a continuous, sustained release of the active hormone. Finally, the intrauterine system Mirena represents both a very effective contraceptive and a specific treatment for menorrhagia.

  12. FPIA helps expand contraceptive services.

    PubMed

    Groot, H

    1984-01-01

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

  13. Health behaviors, chronic disease prevalence and self-rated health of older Asian Indian immigrants in the U.S.

    PubMed

    Jonnalagadda, Satya S; Diwan, Sadhna

    2005-04-01

    The purpose of this study was to examine the correlates of healthy behaviors and self-rated health in middle-aged and older Asian Indian immigrants in the U.S. Asian Indian men (n=162) and women (n=64), 50 years of age or older completed a telephone survey which collected information regarding demographics, behavioral risk factors, acculturation, perceived control, quality of social support, depression, body mass index, chronic disease prevalence, and self-rated health. Participants' average length of residence in the U.S. was 25 years, 52% were normal weight, 41% were vegetarians, 55% incorporated aerobic activity into daily lifestyle, and only 5% smoked. Hypertension and diabetes were most common chronic diseases (31 and 18%, respectively). Younger age, longer length of residence and a bicultural or more American ethnic identity were associated with greater participation in physical activity. Likewise, higher income, a bicultural or more American ethnic identity and depression were associated with higher fat intake. Poor self-rated health was associated with older age, female gender, BMI>25, satisfaction with social support, and greater number of chronic disease conditions. A multitude of factors influence the practice of healthy behaviors and the perceived health of Asian Indian immigrants, which should be addressed when developing culturally appropriate health promotion interventions.

  14. Effectiveness of Hormonal Contraception in HIV-Infected Women using Antiretroviral Therapy: A Prospective Study

    PubMed Central

    Pyra, Maria; Heffron, Renee; Mugo, Nelly R.; Nanda, Kavita; Thomas, Katherine K.; Celum, Connie; Kourtis, Athena P.; Were, Edwin; Rees, Helen; Bukusi, Elizabeth; Baeten, Jared M.

    2015-01-01

    Objective To assess whether antiretroviral therapy (ART) may diminish the effectiveness of hormonal contraceptive methods. Methods Using data from 5,153 HIV-infected women followed prospectively one to three years in three HIV prevention studies in Africa, we compared incident pregnancy rates by contraceptive method (implant, injectable, oral, or none) and ART use. Multivariable Cox regression models were used to determine adjusted hazard ratios (aHR) and test interactions between each method and ART use. Results During follow-up, 9% of women ever used implants, 40% used injectables, and 14% used oral contraceptives; 31% of women ever used ART, mostly nevirapine (75% of ART users) or efavirenz-based (15%). Among women not using contraception, pregnancy rates were 13.2 and 22.5 per 100 women-years for those on and not on ART, respectively. Implants greatly reduced the incidence of pregnancy among both women on ART (aHR 0.06, 95% CI 0.01-0.45) and not on ART (aHR 0.05, 95% CI 0.02-0.11). Injectables (aHR 0.18 on ART and aHR 0.20 not on ART) and oral contraceptives (aHR 0.37 on ART and aHR 0.36 not on ART) also reduced pregnancy risk, though by lesser degrees. ART use did not significantly diminish contraceptive effectiveness, although all methods showed non-statistically significant reduced effectiveness when concurrently using efavirenz. Conclusion Hormonal contraceptive methods are highly effective in reducing pregnancy risk in HIV-infected women, including those concurrently using ART. Studies of potential interactions between ART and contraceptives should evaluate real-world effectiveness of contraceptive methods; in this study, implants were the most effective method to prevent pregnancy, even during ART use. PMID:26544706

  15. Alternatives to oral regimens of contraception.

    PubMed

    Simon, M; Shulman, L P

    2007-06-01

    Alternatives to oral contraceptives are an integral part of contraception used worldwide. In order to empower women to correctly use contraception for as long as they choose not to become pregnant, healthcare practitioners and their patients must be educated about these methods as well as the full spectrum of available birth control options. Effective counseling is a key factor in helping a woman effectively chose a method that is appropriate for her. In order for contraceptive counseling to be effective, information should be accurate and provided in an unbiased manner. This review will help provide healthcare practitioners with current information regarding the use of nonoral contraceptives so as to facilitate the counseling of women and allow them to make informed and appropriate contraceptive decisions.

  16. 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

  17. Prevalence rates of otitis media with effusion from 0 to 2 years of age: healthy-born versus high-risk-born infants.

    PubMed

    Engel, J; Anteunis, L; Volovics, A; Hendriks, J; Marres, E

    1999-03-15

    In a prospective-longitudinal study, prevalence rates of otitis media with effusion (OME) were analysed in 150 healthy-born and 100 high-risk-born infants, aged 0-2 years. In order to determine OME, otoscopy and tympanometry were performed at 3-monthly intervals beginning at term date. The Maastricht Otitis Media with Effusion Study (MOMES) algorithm was used to standardize the diagnosis. The distribution of relevant background characteristics was similar in both groups except for gestational age and birth weight, which were significantly lower (P < 0.001) in the high-risk-born group. The ratio of unilateral:bilateral OME was 2:3. Prevalence rates of OME were strongly associated with age (P < 0.001). During the first months of life, OME prevalence rates increased rapidly in both groups, but did not differ significantly. However, from the age of 6 months on, OME prevalence rates of the high-risk group became significantly higher compared with the normal group (P < 0.05). The peak prevalence of OME (59% in the high-risk group versus 49% in the normal group) was observed around the age of 10 months. Although gradually decreasing prevalence rates were noted in both groups with aging, the differences between high-risk and normal infants remained, at least up to 24 months. In conclusion, OME is a very prevalent, age-dependent disorder during infancy, especially in high-risk infants. Peak prevalence of OME was found in the second half of the first year of life.

  18. Pharmacologic development of male hormonal contraceptive agents.

    PubMed

    Roth, M Y; Amory, J K

    2011-01-01

    The world population continues to increase dramatically despite the existence of contraceptive technology. The use of male hormonal contraception may help in preventing un intended pregnancies and managing future population growth. Male hormonal contraception relies on the administration of exogenous hormones to suppress spermatogenesis. Clinical trials have tested several regimens using testosterone, alone or in combination with a progestin. These regimens were shown to be >90% effective in preventing conception and were not associated with serious adverse events.

  19. [Chorea and the use of contraceptives].

    PubMed

    Despland, P A; Dufresne, J J; Regli, F

    1976-08-01

    A 20-year-old nullipara without previous history of chorea or rheumatic fever developed unilateral chorea 11 months after first taking oral contraceptives. All laboratory findings were normal except for considerable elevation of the triglycerides. Complete remission of the extrapyramidal disorder occurred within 4 months of discontinuing the contraceptive preparation. It is suggested that the contraceptive steroids may influence some metabolic events which produce vascular changes. PMID:1006233

  20. Contraception technology: past, present and future.

    PubMed

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

    2013-03-01

    Steady progress in contraception research has been achieved over the past 50 years. Hormonal and nonhormonal 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 and estradiol valerate 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. Although 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 nonhormonal methods is still at an early stage of research, with the identification of specific targets within the reproductive system in ovaries and testes, as well as

  1. [Contraception and pelvic infection in women].

    PubMed

    Keith, L; Berger, G S; Brown, E R

    1986-01-01

    Although sexually transmitted diseases are a major public health problem at the international level, the relationship between contraception and pelvic infection is seldom examined. Numerous STDs are more difficult to diagnose, more frequent, and more serious in women than in men. Differential diagnosis between pelvic infection and other intraabdominal syndromes has been a concern for practitioners for years, and many pelvic infections are probably never diagnosed. Lower abdominal pain and sensitivity as well as fever, leucocytosis, accelerated sedimentation rate, inflammatory annexial mass evident on sonography, and microorganisms in the pouch of Douglass and presence of leucocytes in the peritoneal fluid are diagnostic criteria. Apart from errors in treatment resulting from errors in diagnosis, pelvic infections are often inadequately treated, especially in the initial phase before symptoms are confirmed. The exact incidence of pelvic infections in the US is unknown, but pelvic inflammatory disease (PID) accounted for over 200,000 hospitalizations per year between 1970-75. PID carries grave risks of subsequent ectopic pregnancy, chronic pelvic pain, and infertility which is more likely as the number of acute episodes increases. The female genital tract has diverse microenvironments propitious for growth of microorganisms of different types, aerobic and anaerobic. Each anatomic site has specific features conditioning bacterial growth. Histological modifications during the menstrual cycle and pregnancy affect the microbial flora. Except in the case of gonorrhea, it is not known how many female lower genital tract infections spread to the upper tract. Since 1970, several studies have domonstrated a growing diversity of cervical and vaginal flora in asymptomatic subjects. The principal risk factors for PID have been well described in the literature. All contraceptive methods except the IUD provide some degree of protection against PID. Even among IUD users the risk of

  2. Urban minority women’s perceptions of and preferences for postpartum contraceptive counseling

    PubMed Central

    Yee, Lynn; Simon, Melissa

    2011-01-01

    Objective Focused antenatal contraceptive counseling about postpartum contraception may reduce the risk of contraceptive nonuse and misuse, although the optimal timing, content, and communication style of such counseling remain controversial. This study used an in-depth qualitative approach in a population of young, postpartum, urban minority women in order to examine women’s perspectives toward the optimal provision of comprehensive contraceptive counseling. Methods Brief surveys and semi-structured interviews were conducted with 30 consenting postpartum women. In-person one-on-one interviews were then reviewed for themes, using an iterative process. Qualitative analysis techniques identifying emergent themes were applied to interview data. Results In this cohort of African American (63%) and Hispanic (37%) women (median age 26), 73% had unplanned pregnancies. Women preferred frequent, short sessions of provider-initiated comprehensive contraceptive counseling throughout the antepartum period with reinforcement of decisions while postpartum. Participants valued patient-centered counseling that is inclusive of all appropriate methods and personalized to individual needs. Conclusion We recommend that frequent, provider-initiated, multiple-modality discussions of appropriate postpartum contraceptive options should take place throughout pregnancy in an open, individualized manner. Further work should address the long-term effects of improved patient-centered antenatal contraceptive counseling on rates of unintended pregnancy. PMID:21323851

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

    ERIC Educational Resources Information Center

    Hansen, Thomas; Skjeldestad, Finn Egil

    2003-01-01

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

  4. 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 ...

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

    PubMed

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

    2014-11-01

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

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

    PubMed

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

    2007-09-01

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

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

    PubMed

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

    2007-09-01

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

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

    PubMed Central

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

    2011-01-01

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

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

    PubMed

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

    2011-05-01

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

  10. Male experiences of unintended pregnancy: characteristics and prevalence

    PubMed Central

    Kågesten, Anna; Bajos, Nathalie; Bohet, Aline; Moreau, Caroline

    2015-01-01

    STUDY QUESTION What are the characteristics and circumstances of pregnancies men report as unintended in France? SUMMARY ANSWER Pregnancies reported as unintended were most prevalent among young men with insecure financial situations, less stable relationships and inconsistent use of contraception or false assumptions about their partner's use of contraception. WHAT IS KNOWN ALREADY Efforts to involve men in family planning have increased over the last decade; however, little is known about factors associated with men's pregnancy intentions and associated contraceptive behaviours. STUDY DESIGN, SIZE, DURATION The data presented in this study were drawn from the nationally representative FECOND study, a population-based survey conducted in France in 2010. The sample comprised 8675 individuals (3373 men), aged 15–49 years, who responded to a telephone interview about socio-demographics and topics related to sexual and reproductive health. The total refusal rate was 20%. PARTICIPANTS/MATERIALS, SETTING, METHODS This study included 2997 men, of whom 664 reported 893 recent pregnancies (in the 5 years preceding the survey). Multivariate Poisson's regression with population-averaged marginal effects was applied to assess the individual and contextual factors associated with men's intentions for recent pregnancies. The contraceptive circumstances leading to the unintended pregnancies were also assessed. MAIN RESULTS AND THE ROLE OF CHANCE Of all heterosexually active men, 5% reported they had experienced an unintended pregnancy with a partner in the last 5 years. A total of 20% of recent pregnancies reported by men were qualified to be unintended, of which 45% ended in induced abortion. Of pregnancies following a previous unintended pregnancy, 68% were themselves unintended. Among all heterosexually active men, recent experience of an unintended pregnancy was related to age, mother's education, age at first sex, parity, contraceptive method history, lifetime number of

  11. Choosing a contraceptive. What's best for you?

    PubMed

    Anthony, J

    1994-04-01

    New types of contraception approved for use in the US include two long-lasting, hormone-based contraceptives, Depo-Provera and Norplant, and the female condom. The female condom is made of polyurethane, which is thinner, stronger, and a better conductor of heat than latex. Its inner ring fits over the cervix and the outer ring protects the labia and the base of the penis. Its typical-use and perfect-use failure rates are 21-26% and around 5%, respectively. One injection of Depo-Provera blocks ovulation for 3 months. Irregular periods are common with Depo-Provera use. Fertility may not return for 6-12 months after discontinuation. Depo-Provera may protect against endometrial cancer. The 6-capsule system Norplant is inserted subdermally in the arm and releases levonorgestrel for up to 5 years. Since its arrival on the US market, more than 900,000 women have used Norplant. Contraindications to Norplant are liver disease, blood clots, inflammation of the veins, history of breast cancer, or breast feeding in the first 6 weeks postpartum. More than 600,000 US women undergo sterilization annually. 25% of all heterosexually active, fertile women of reproductive age and 60% of these women ages 35-44 have had a tubal ligation. Vasectomy is less risky than tubal ligation. Both vasectomy and tubal sterilization are more than 99% effective. Oral contraceptives (OCs) suppress ovulation. 28% of US women of reproductive age use OCs. OCs are more than 99% effective. OCs appear to increase the risk of blood clots, heart attack, and stroke for smokers over 35. Health benefits of OCs include protection against ovarian cancer, endometrial cancer, pelvic inflammatory disease, ovarian cysts, and benign breast tumors. Barrier methods keep sperm from joining the egg. Latex condoms protect against sexually transmitted diseases (STDs). IUDs interfere with sperm transport and egg fertilization. In the US, there is a perception that IUD use is unsafe. Women with new or multiple partners should

  12. [Choice of contraception for the diabetic woman].

    PubMed

    Athea, N; Kuttenn, F

    1983-01-01

    The absolute need to limit and program pregnancies in diabetic women demands choice of an adequate contraceptive method. Combined oral contraceptives (OCs) do not seem appropriate because of their diabetogenic effects and the added vascular risks they present to already fragile women. The diabetogenic effects of combined OCs are believed to result from a reduced number and affinity of insulin receptors, augmented secretion of STH, vitamin B6 deficiency, or hepatic effects. Some progestagens have been shown to stimulate deleterious effects of estrogens on OCs. The estrogen component of OCs is associated with elevation of triglyceride levels and stimulation of very low density lipoprotein synthesis. To these vascular risks are added an augmented blood pressure which reaches hypertensive levels in 50% of cases. The effects of synthetic estrogens on coagulation factors and vessel walls have been well deomonstrated. Macrodosed progestagen pills taken in 20-day cycles appear to be an interesting alternative, but those with the most constant antigonadotropic activity are derived from nortestosterone and all have to some degree an anabolizing androgenic effect which may result in weight gain. Derivatives of 17-hydroxyprogesterone appear to be without secondary metabolic effects. Cyproterone acetate should be evaluated as a possible OC for diabetic women. Continuous-dose progestagen micropills are highly recommended for diabetic women because of their excellent metabolic tolerance. The action of this type of pills is essentially peripheral. The pill may cause menstrual irregularity, spotting, or amenorrhea, and an increased rate of ectopic pregnancy. The Pearl index is between .8-2/1009 IUDs are a possibility for diabetic women, but because of their increased vulnerability to infection, such women should be carefully screened for prior adnexial or uterine infection, the device should be inserted in completely aseptic conditions, the woman's hygiene should be impeccable, the

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

    PubMed Central

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

    2015-01-01

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

  14. IMAP statement on contraceptive counselling.

    PubMed

    1994-06-01

    Decisions regarding sexual and reproductive behavior involve biomedical, cultural, socioeconomic, and ethical considerations, and have a major impact upon personal and family life over both the long and short terms. Family planning service providers should therefore help their clients assess such issues, especially when permanent or long-term decisions are of issue. Contraceptive counselling is a two-way process of communication characterized by an exchange of information and views, discussion, and deliberation. Research demonstrates that contraceptive use improves when service delivery personnel listen and respond to clients' worries and concerns. Considerations should be given to the following issues when counseling clients on the use of contraception: the technical competence of the counselor and the quality of interaction with clients; tailoring counseling to meet clients' characteristics and needs, with priority given to discussing any issues the clients choose; encouraging useful discussion without overwhelming the client with information; gaining clients' confidence to help them voice personal concerns, yet not infringing upon their privacy; providing counseling in privacy; avoiding misunderstandings and the omission of important information or instructions; and not expecting clients to learn everything in one counseling session. Counseling should instead be supplemented by other means of education and information such as group sessions, posters, leaflets, and videos. Training in counseling, and counseling in special situations such with adolescents, perimenopausal women, postpartum and post abortion women, and women with medical disorders are discussed. A supplement to the statement focuses upon the social and health problems which arise when family planning services and sex education for adolescents are limited or absent.

  15. Hysteroscopy and contraception.

    PubMed

    Veersema, Sebastiaan

    2015-10-01

    The Essure method is the only available hysteroscopic sterilisation method. A 4-cm device is placed in the fallopian tubes, which then induces an inflammatory reaction that causes occlusion. The method has a high successful placement rate and high effectiveness, and it can be performed in an office setting without anaesthesia. Three months after the procedure, a confirmation test has to be conducted to assure a correct position of the micro-inserts and tubal occlusion. This test can be performed by hysterosalpingography (HSG), plain X-ray or ultrasound. Pregnancies reported after Essure sterilisation are, in a majority, related to non-adherence to the follow-up protocol or misreading of the confirmation test. A majority of the pregnancies occurred after HSGs that were determined to have been misinterpreted, including missed expulsion or perforation of the micro-insert. Other complications such as ectopic pregnancy and allergic reaction to the micro-inserts seem to have been described to be of low incidence. PMID:26013880

  16. Understanding Adolescent Contraceptive Choice: An Empirical Test.

    ERIC Educational Resources Information Center

    Adler, Nancy E.; And Others

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

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

    ERIC Educational Resources Information Center

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

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

  18. Contraceptive use for planned parenthood patients.

    PubMed

    Savel, L E

    1990-06-01

    Three hundred consecutive new patients coming to Planned Parenthood clinics were reviewed. Of these patients, 68.3 percent were not using contraception and 67.8 percent had never used contraception. Also, 35.1 percent had experienced one or more pregnancies, and 52 percent had first coitus before 16 years of age.

  19. Barriers to contraceptive use among Pakistani couples.

    PubMed

    Harel, K

    1997-01-01

    Despite the existence of a family planning program in Pakistan since 1965 and widespread knowledge among Pakistanis about contraception, there is a high level of unmet need for family planning. One recent survey found that while 53% of married women express the desire to avoid pregnancy, less than 20% use contraception. A recent Population Council study conducted in urban and rural areas of Punjab province investigated personal beliefs, family circumstances, social norms, and gender relations among 1310 married women and 554 of their husbands. The unmet need for contraception was highest among women over age 30 years, those with more living children, less educated women, and women living in rural areas. The study found that while most Pakistanis approve of family planning, obstacles to contraceptive use exist in most marriages. 97% of respondents who wanted another child wished for a boy. That preference for sons influences contraceptive use behavior. The fear of social disapproval of contraceptive use, perceived opposition from in-laws and husbands, and fear of health side effects and divine punishment were major reasons identified against contraceptive use. Female contraceptive users were more autonomous and likely to make domestic decisions without consulting their husbands, while husbands defer to social and cultural norms. PMID:12292988

  20. Model for Effective Contraceptive Counseling on Campus.

    ERIC Educational Resources Information Center

    Bachmann, Gloria A.

    1981-01-01

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

  1. La contraception de l'adolescente

    PubMed Central

    Pinsonneault, Odette

    1991-01-01

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

  2. Adolescent Peers as Facilitators of Contraceptive Use.

    ERIC Educational Resources Information Center

    Zuehlke, Martha E.; Rogel, Mary J.

    This paper describes the Young Adult and Adolescent Decision Making About Contraception program, an ongoing clinical research project designed to address the problem of unplanned adolescent pregnancy from a biopsychosocial perspective. The program is described as a peer-led intervention to promote the use of contraception by teenage girls at high…

  3. Factors influencing married youths' decisions on contraceptive use in a rural area of Myanmar.

    PubMed

    Myo-Myo-Mon; Liabsuetrakul, Tippawan

    2009-09-01

    This study aimed to describe the factors influencing the decision of married female youth and their husbands measured by self-rating on the magnitude and importance of each factor and person, and agreement between willingness to use and actual contraceptive use. A community-based cross-sectional study was conducted in Ayeyarwaddy Division, Myanmar. The decision to use contraception increased significantly due to motivation from a provider, friends, spousal communication, and benefits of contraception by multiple logistic regression. Influencing factors which attained the magnitude of >50% and importance of >5 scores for their decision were a couple's attitude, spousal communication, pregnancy susceptibility, couple's knowledge, and benefit of contraception. A fair agreement was found between willingness to use and actual use.

  4. Estrogen-free oral hormonal contraception: benefits of the progestin-only pill.

    PubMed

    de Melo, Nilson Roberto

    2010-09-01

    Although combined oral contraceptives (COCs) are commonly used and highly effective in preventing pregnancy, they may not be suitable for some women. COC use is associated with increased rates of cardiovascular events and is not recommended in nonbreastfeeding women in the immediate postpartum period or in breastfeeding women during the initial 6 months of breastfeeding. Moreover, estrogen-related adverse effects, such as headache, are common. Estrogen-free progestin-only pills (POPs) are a valuable option in women who prefer to take an oral hormonal contraceptive, but are ineligible for, or choose not to use, COCs. Although some POPs have been associated with lower contraceptive effectiveness than COCs, the POP containing desogestrel has shown similar contraceptive effectiveness to COCs. The most commonly reported complaints in women using all POPs are bleeding problems. Counseling women interested in using POPs about the variable bleeding patterns associated with this method may improve compliance and acceptance. PMID:21080791

  5. International standardization of mechanical contraceptives.

    PubMed

    Mellstam, S

    1983-06-01

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

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

    PubMed

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

    1987-11-01

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

  7. [Badly resolved triad: sexuality, contraception and pregnancy].

    PubMed

    Oliane, A H

    1993-09-01

    Sexuality, contraception, and pregnancy are inseparable, yet they are a taboo subject both for the whole country and for adolescents. The ever-earlier awakening of sexuality requires educational mechanisms that assign fundamental importance to the implementation of social, psychological, and cultural protection strategies. The resolution of pregnancy is dependent on income just as maternity is secondary to financial independence. The majority of rich adolescents get an abortion, while poor adolescents carry to term their undesired pregnancies. Adolescence is a phase of confusion with peculiar psychosocial and cultural aspects. In the low-income population the start of formal education is precarious and delayed, an important factor in the discrepancies between well-to-do and poor social classes. Pregnancy and abortion rates vary according to economic conditions, however, their resolution clearly shows ethical, religious, and moral subjectivity. The media, rural exodus, increasing urbanization, and the economic crisis make maternity a less dominant aspect of women's lives. Young people do not obtain the necessary information for safeguarding their fertility because of the lack of specialized services, thus they are uncertain about what the health care system can provide. Much opportunity is lost because professionals are too busy or too disinterested to listen to these alienated youngsters. Preconceived notions, disinformation, and uncertainty coupled with emotional obstacles and noncooperation of the partner result in the use of contraceptives becoming a complex and difficult problem to resolve. It is necessary to alter our perceptions of adolescent sexual development. In Brazil, where more than half of the population is young, it is indispensable to devise collective programs not restricted to conventional medical practices to reach all adolescents.

  8. Venous thromboembolism in women taking hormonal contraceptives.

    PubMed

    Blanco-Molina, Angeles; Monreal, Manuel

    2010-02-01

    Hormonal contraceptives are a popular method of contraception, but their use has been associated with an increased risk for venous thromboembolism. In order to reduce such risk, these compounds have been changed in their dosage, chemical composition and route of administration. The absolute risk of death from pulmonary embolism in contraceptive users has been estimated to be 10.5 (95% CI: 6.2-16.6) per million woman-years. The safest option is an oral contraceptive containing levonorgestrel combined with a low dose of estrogen. Identifying women at increased risk for venous thromboembolism is difficult, and greater use of thromboprophylaxis during immobility or minor surgery should be warranted. Several authors have called for all women to be screened for thrombophilia before prescription of hormonal contraceptives, but its cost-effectiveness remains uncertain.

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

    SciTech Connect

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

    1982-06-01

    Reported are biliary lipid composition and secretion, bile acid composition and kinetics, and gallbladder function in a group of healthy, nonobese women taking a contraceptive steroid preparation. A comparable group of healthy women served as controls. Biliary lipid secretion rate was measured by the marker perfusion technique. Bile acid distribution was determined by gas-lipid chromatography. The pool size, FTR, and synthesis rate of each bile acid were measured by using CA and CDCA labeled with the stable isotope of carbon, /sup 13/C. In some of the subjects gallbladder storage and emptying were measured during the kinetic study, by real-time ultrasonography. Contraceptive steroid use was associated with a significant increase in biliary cholesterol saturation and in the lithogenic index of bile. The rate of cholesterol secretion in the contraceptive steroid group was 50% greater than in the control (p << 0.001) and the rate of bile acid secretion was reduced (p < 0.02). The total bile acid pool size was significantly increased by contraceptive steroids. The major increase occurred in the CA pool (p < 0.04). The daily rate of enterohepatic cycles of the bile acid pool was decreased by contraceptive steroids from 6.6 to 4.3 (p < 0.01). The only effect of contraceptive steroids on gallbladder function was a slower emptying rate in response to intraduodenal amino acid infusion. No index of gallbladder function correlated significantly with any parameter of bile acid kinetics in this small group of subjects. The findings confirm the lithogenic effect of contraceptive steroids and indicate that its causes are an increase in cholesterol secretion and a decrease in bile acid secretion.

  10. High prevalence rate of pituitary incidentaloma: is it associated with the age-related decline of the sex hormones levels?

    PubMed

    Kastelan, Darko; Korsic, Mirko

    2007-01-01

    Incidental pituitary adenoma is the common finding during brain imaging. According to multistep model of pituitary tumourigenesis genetic alterations provide the initiating event that transforms cells while hormones play a role in promoting cell proliferation. Development of pituitary adenoma in a case of excessive hypophysiotrophic hormones production or reduced feedback suppression by target gland hormones emphasizes the importance of hormonal stimulation in pituitary tumourigenesis. Pituitary hyperplasia has been reported in pregnancy, hypothyroidism and conditions such as CRH or GHRH hypersecretion. Moreover, recent study reported one case of gonadotroph macroadenoma and two cases of gonadotroph cells hyperplasia in patients with Klinefelter syndrome probably due to protracted stimulation of gonadotroph cells because of lack of androgen feedback. Significant changes of the hypothalamic-pituitary-gonadal axis occurred with aging. In females, after menopause, estradiol level decreases by 35-fold and estrone level by 20-fold that results in increased gonadotropins levels. Similarly, FSH, but not LH, level is increased with advancing age in men, too, although the age-related difference in the level is less in comparison with women. Regarding these data, we hypothesised that high prevalence rate of pituitary incidentaloma in the elderly is associated with age-related decline in sex hormones levels and subsequent lack of feedback suppression leading to permanent gonadotrophs stimulation which is the crucial step in the pituitary tumour development. According to previously mentioned multistep model of pituitary tumourigenesis, incidentaloma will develop only in persons with already present intrinsic pituitary cell defects. However, further studies have to answer the questions of whether the incidence of pituitary tumours is more frequent in elderly, whether women with late onset menopause or those taking long-term hormone replacement therapy have lower rate of

  11. Self-rated Health and Internet Addiction in Iranian Medical Sciences Students; Prevalence, Risk Factors and Complications

    PubMed Central

    Mohammadbeigi, Abolfazl; Valizadeh, Farzaneh; Mirshojaee, Seyede Roqaie; Ahmadli, Robabeh; Mokhtari, Mohsen; Ghaderi, Ebrahim; Ahmadi, Ali; Rezaei, Heshmatollah; Ansari, Hossein

    2016-01-01

    Introduction: Self-rated health is a brief measure for general health. It is a comprehensive and sensitive index for prediction of health in future. Due to the high internet usage in medical students, the current study designed to evaluate the self-rated health (SRH) in relationship with internet addiction risk factors in medical students. Methods: This cross sectional study conducted on 254 students of Qom University of Medical Sciences 2014. Participants selected by two stage sampling method including stratified and simple random sampling. The Young’s questionnaire of internet addiction and SRH question used for data collection. Chi-square, t-test, and logistic regression used in data analysis. Results: More than 79.9% of students reported their general health good and very good. The student’s mean score of general health was higher than the average. In addition, the prevalence of internet addiction was 28.7%. An inverse significant correlation observed between SRH and internet addiction score (r=-0.198, p=0.002). Using internet for Entertainment, using private Email and chat rooms were the most important predictors of affecting to internet addiction. Moreover, internet addiction is the most predictors of SRH and increased the odds of bad SRH. Conclusion: The good SRH of medical students was higher than general population but in health faculty’ students were lower than others. Due to the effect of internet addiction on SRH and increasing trend of internet use in medical students, as well as low age of participants, attention to psychological aspects and the job expectancy in future, can effective on increasing the good SRH. PMID:27493592

  12. 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

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

    PubMed Central

    Barengo, Noël C.; Tamayo, Diana Carolina

    2015-01-01

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

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

    PubMed

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

    2014-08-01

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

  15. State-of-the-art of non-hormonal methods of contraception: II. Chemical barrier contraceptives.

    PubMed

    Batár, István

    2010-04-01

    Chemical contraceptives mainly known as spermicides are one of the oldest types of contraceptives. The industrial revolution facilitated new developments, and they became a leading and widespread method. However, their use declined in the second half of the 20th century, and came under focus again only with the upsurge of sexually transmitted infections (STIs). The effectiveness of spermicides depends on the users' compliance and pregnancy rates vary widely: from 6/100 woman-year (with perfect use) to 26/100 woman-year (with typical use). Preparations consist of two components: an excipient (foam, cream, jelly, soluble film, suppository or tablet); and a chemical agent with spermicidal properties (acidic compound, microbicidal agent, detergent). The most widely used active agent has been the surface active (detergent) nonoxynol-9 (N-9). Based on their mode of action (surfactant effect of detergents, enzymatic action of microbicides on cell metabolism) spermicides were thought to provide protection against STIs including HIV. Recent studies have, however, shown that detergents may actually increase the risk. Because of this, there is an urgent need for a suitable non-detergent spermicide, and research should focus on developing new compounds to replace N-9 and other agents having similar undesired effects. This paper reviews the latest studies reporting results on these recent developments. PMID:20055729

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

    PubMed Central

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

    2013-01-01

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

  17. A review of "once-a-month" combined injectable contraceptives.

    PubMed

    Newton, J R; D'arcangues, C; Hall, P E

    1994-01-01

    The once-a-month combined progestogen and estrogen injectables were developed to overcome menstrual irregularity, a major reason for discontinuation of progestogen-only contraceptives. About 2 million women have already used the combined once-a-month injectables, particularly in Latin America and China. The currently available once-a-month combined injectable contraceptives are Chinese Injectable No. 1 (17 alpha-hydroxyprogesterone caproate, estradiol valerate), another formulation marketed under various brand names in Latin America (dihydroxyprogesterone acetophenide, estradiol enanthate), Cyclofem (medroxyprogesterone acetate [MPA], estradiol cypionate), Mesigyna (norethisterone enanthate, estradiol valerate), and Mego-E (megestrol acetate, 17 beta-estradiol). Cyclofem and Mesigyna are very effective at preventing pregnancy (1-year rate, 99.8-99.6%). The rate for the dihydroxyprogesterone acetophenide/estradiol enanthate formulation is 100%, while that for Chinese Injectable No. 1 is 94%. Even though menstrual disturbances occur less often in once-a-month injectable users, they are the leading medical reason for discontinuation. At 1 year of use, about 70% of Cyclofem and Mesigyna users have regular bleeding patterns compared to 8% of Depo-Provera users. None of the Cyclofem and Mesigyna studies have found them to induce any adverse or clinically relevant metabolic changes. Once-a-month combined estrogen and progestogen injectables do not cause any significant delay in return to ovulation, but researchers should collect more data on conception rates for women who discontinue for planned pregnancy and those who discontinue for bleeding disorders and amenorrhea. Research into service delivery of these injectables is needed to assess managerial requirements or adaptations that would be required should there be more wide scale introduction of a contraceptive into both public and private sectors. Age, contraceptive history, learning about injectables and husbands

  18. Adolescent women's contraceptive decision making.

    PubMed

    Weisman, C S; Plichta, S; Nathanson, C A; Chase, G A; Ensminger, M E; Robinson, J C

    1991-06-01

    A modified rational decision model incorporating salient events and social influences (particularly from sexual partners) is used to analyze adolescent women's consistent use of oral contraceptives (OCs) over a six-month period. Data are taken from a panel study of 308 clients of an inner-city family planning clinic. Expected OC use was computed for each subject on the basis of subjective expected utility (SEU) theory, and is found in multivariate analyses to be a significant predictor of actual OC use. In addition, variables representing baseline and follow-up partner influences, the salience of pregnancy for the subject, and positive side effects of OCs during the first months of use are found to predict OC use. Partner's support of OC use during follow-up and positive side effects of OCs are found to predict OC use among subjects for whom OC use was not the expected decision according to baseline SEU. Implications of the findings for models of adolescents' contraceptive behavior and for clinicians are discussed. PMID:1861049

  19. Australian scientists develop male contraceptive.

    PubMed

    1974-05-20

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

  20. Adolescent women's contraceptive decision making.

    PubMed

    Weisman, C S; Plichta, S; Nathanson, C A; Chase, G A; Ensminger, M E; Robinson, J C

    1991-06-01

    A modified rational decision model incorporating salient events and social influences (particularly from sexual partners) is used to analyze adolescent women's consistent use of oral contraceptives (OCs) over a six-month period. Data are taken from a panel study of 308 clients of an inner-city family planning clinic. Expected OC use was computed for each subject on the basis of subjective expected utility (SEU) theory, and is found in multivariate analyses to be a significant predictor of actual OC use. In addition, variables representing baseline and follow-up partner influences, the salience of pregnancy for the subject, and positive side effects of OCs during the first months of use are found to predict OC use. Partner's support of OC use during follow-up and positive side effects of OCs are found to predict OC use among subjects for whom OC use was not the expected decision according to baseline SEU. Implications of the findings for models of adolescents' contraceptive behavior and for clinicians are discussed.

  1. Contraceptive methods and ovarian cancer risk among Chinese women: A report from the Shanghai Women's Health Study.

    PubMed

    Huang, Zhezhou; Gao, Yutang; Wen, Wanqing; Li, Honglan; Zheng, Wei; Shu, Xiao-Ou; Beeghly-Fadiel, Alicia

    2015-08-01

    Oral contraceptive use is associated with reduced ovarian cancer risk; however, associations with other contraceptive methods, such as intrauterine device (IUD) and tubal ligation, are less clear. Women in China differ from western women in regard to mechanisms and duration of use of contraception. This study was undertaken to evaluate associations between contraceptive methods and ovarian cancer risk using data from the prospective Shanghai Women's Health Study. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated by Cox proportional hazards regression. A total of 174 epithelial ovarian cancer cases were found to occur among 70,259 women who were followed-up for a total of 888,258 person-years. The majority of women had ever used any contraception (77.0%), including IUD (55.6%), oral contraceptive (20.4%), tubal ligation (14.7%) or contraceptive shots (2.6%). Ever use of any contraception was associated with a nonsignificant reduction in ovarian cancer risk (HR: 0.86, 95% CI: 0.60-1.24). Longer duration of IUD use was associated with lower ovarian cancer risk (p-value for trend = 0.04). Compared with never users, women with durations of IUD use longer than the median (20 years) were 38% less likely to develop ovarian cancer (HR: 0.62, 95% CI: 0.40-0.97). Based on the high prevalence and long duration of IUD use among Chinese women, we estimate a preventive fraction of 9.3%, corresponding to approximately 16 ovarian cancer cases. High prevalence of long-term IUD use may, therefore, contribute to the low incidence of ovarian cancer observed in China.

  2. Social Transmission and the Spread of Modern Contraception in Rural Ethiopia

    PubMed Central

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

    2011-01-01

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

  3. Intimate Partner Violence: Associated Factors and Acceptability of Contraception Among the Women

    PubMed Central

    Mundhra, Rajlaxmi; Singh, Nilanchali; Kaushik, Somya; Mendiratta, Anita

    2016-01-01

    Objective: To determine the prevalence of various types of domestic violence and to find out the impact of intimate partner violence (IPV) on adoption of contraceptive measures among the women who are victim to this. Materials and Methods: This questionnaire-based, cross-sectional study was conducted in the department of obstetrics and gynecology of a tertiary care hospital in Delhi. Four hundred and one postpartum females were randomly selected over a period of 5 months and were questioned about their age, parity, educational status, occupation, husband's education, monthly family income, and, if present, IPV in detail. These study participants were enquired about their contraceptive knowledge and use. Results: Sexual violence was seen in 38.4% of the cases, physical violence in 22.4% of the cases, and verbal abuse was seen in nearly 32.7% of the cases. In response to any of the three violence faced, only 23 women (11.79%) reacted by discussing with parents and friends. In 4.61% of the cases, the violence was so severe that she had to inform police. This study showed that higher percentage of women without IPV accepted immediate postpartum contraception methods as compared to those with IPV (35.9% vs. 25%, P = 0.023), but the overall frequency of using contraceptive methods was higher in those with IPV as compared to those without IPV (49% vs. 47%, P = 0.690). Conclusion: IPV is associated with increased contraceptive adoption. PMID:27385873

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

    ERIC Educational Resources Information Center

    Scales, Peter

    1977-01-01

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

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

    ERIC Educational Resources Information Center

    Chng, Chwee Lye

    1983-01-01

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

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

    ERIC Educational Resources Information Center

    Rosenthal, Martha S.

    2010-01-01

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

  7. 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…

  8. Associations of Undergoing a Routine Medical Examination or Not with Prevalence Rates of Hypertension and Diabetes Mellitus: A Cross-Sectional Study

    PubMed Central

    Zhang, Lin; Zhang, Wei; Zhang, Lingling; Tian, Danping; Li, Li; Deng, Xin; Deng, Jing; Ning, Peishan; Hu, Guoqing

    2016-01-01

    Background: Undergoing a routine medical examination may be associated with the prevalence rate of chronic diseases from a population-based household interview survey. However, this important issue has not been examined so far. Methods: Data came from the first health service household interview of Hunan province, China, in 2013. A Rao–Scott chi-square test was performed to examine the difference in prevalence rates between subgroups. Adjusted odds ratio (OR) was calculated using the PROC SURVEYLOGISTIC procedure of SAS9.1 statistical software. Results: In total, 24,282 residents of 8400 households were surveyed. A higher proportion of elderly adults had undergone a medical examination within the prior 12 months compared with young adults (≥65 years, 60%; 45–64 years, 46%; 18–44 years, 37%). After controlling for location, sex, and household income per capita, undergoing a medical examination was significantly associated with high prevalence rates of hypertension (adjusted OR: 2.0, 95% CI: 1.1–3.5) and of diabetes mellitus (adjusted OR: 3.3, 95% CI: 1.7–6.5) for young adults aged 18–44 years. The associations were not statistically significant for age groups 45–64 years and 65 years or older. Conclusion: The prevalence rates of hypertension and diabetes mellitus may be seriously underestimated for young adults not undergoing a routine medical examination in a health household interview survey. PMID:27347985

  9. Controversies in contraception for women with epilepsy.

    PubMed

    Thomas, Sanjeev V

    2015-01-01

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

  10. Controversies in contraception for women with epilepsy

    PubMed Central

    Thomas, Sanjeev V.

    2015-01-01

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

  11. Power in college students' contraceptive decisions.

    PubMed

    McCormick, N B; Gaeddert, W

    1989-02-01

    Excluding Hollerbach (1980), previous fertility researchers have paid little attention to contraceptive power bases, relationships that become the source of changes in birth control values and behavior. Eight contraceptive power bases, each evaluated as a direct or obvious strategy, were identified in a pilot study involving 25 college students as participants and 10 undergraduate raters. Two-hundred college students completed a questionnaire which included the Bem Sex Role Inventory, inquired into their sexual and contraceptive behavior, and asked about contraceptive power bases. There were highly significant main effects for both students' personal experiences with contraceptive power bases and for their opinions about the comfort and effectiveness of same. Coercion was the most popular and legitimate power was the least popular power base. Women were more likely than men to be the targets of contraceptive power bases, the majority of which were stereotyped as feminine by women in particular. Sex role identification was unrelated to students' experiences with contraceptive power bases. The implications of these findings for family-planning researchers and practioners are addressed.

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

    PubMed Central

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

    1991-01-01

    We surveyed two general population samples aged 8 to 64 living in the unpolluted, rural area of the Po Delta (northern Italy) (n = 3289) and in the urban area of Pisa (central Italy) (n = 2917). Each subject filled out a standardized interviewer-administered questionnaire. The Pisa sample was divided into three groups according to their residence in the urban-suburban areas and to outdoor air pollution exposure (automobile exhaust only or industrial fumes as well). Significantly higher prevalence rates of all the respiratory symptoms and diseases were found in Pisa compared with the Po Delta. In particular, rhinitis and wheezing symptoms were higher in all the three urban zones; chronic cough and phlegm were higher in the zone with the automobile exhaust and the additional industrial exposure. Current smoking was more frequent in the rural area, but the urban smokers had a higher lifetime cigarette consumption. Childhood respiratory trouble and recurrent respiratory illnesses were evenly distributed. Exposure to parental smoking in childhood and lower educational level were more frequent in Po Delta, whereas familial history of respiratory/allergic disorders and work and indoor exposures were more often reported in the city. Multiple logistic regression models estimating independently the role of the various risk factors showed significant odds ratios associated with residence in Pisa for all the symptoms but chronic phlegm. For example, those living in the urban-industrial zone had an odds ratio of 4.0 (4.3-3.7) for rhinitis and 2.8 (3.0-2.6) for wheeze with respect to those living in the Po Delta.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1954948

  13. 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

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

    PubMed

    Potter, J; Santelli, J S

    2015-02-01

    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.

  15. Vouchers in Fragile States: Reducing Barriers to Long-Acting Reversible Contraception in Yemen and Pakistan.

    PubMed

    Boddam-Whetham, Luke; Gul, Xaher; Al-Kobati, Eman; Gorter, Anna C

    2016-08-11

    In conflict-affected states, vouchers have reduced barriers to reproductive health services and have enabled health programs to use targeted subsidies to increase uptake of specific health services. Vouchers can also be used to channel funds to public- and private-service providers and improve service quality. The Yamaan Foundation for Health and Social Development in Yemen and the Marie Stopes Society (MSS) in Pakistan-both working with Options Consultancy Services-have developed voucher programs that subsidize voluntary access to long-acting reversible contraceptives (LARCs) and permanent methods (PMs) of family planning in their respective fragile countries. The programs focus on LARCs and PMs because these methods are particularly difficult for poor women to access due to their cost and to provider biases against offering them. Using estimates of expected voluntary uptake of LARCs and PMs for 2014 based on contraceptive prevalence rates, and comparing these with uptake of LARCs and PMs through the voucher programs, we show the substantial increase in service utilization that vouchers can enable by contributing to an expanded method choice. In the governorate of Lahj, Yemen, vouchers for family planning led to an estimated 38% increase in 2014 over the expected use of LARCs and PMs (720 vs. 521 expected). We applied the same approach in 13 districts of Punjab, Khyber Pakhtunkhwa (KPK), and Sindh provinces in Pakistan. Our calculations suggest that vouchers enabled 10 times more women than expected to choose LARCs and PMs in 2014 in those areas of Pakistan (73,639 vs. 6,455 expected). Voucher programs can promote and maintain access to family planning services where existing health systems are hampered. Vouchers are a flexible financing approach that enable expansion of contraceptive choice and the inclusion of the private sector in service delivery to the poor. They can keep financial resources flowing where the public sector is prevented from offering services

  16. Vouchers in Fragile States: Reducing Barriers to Long-Acting Reversible Contraception in Yemen and Pakistan

    PubMed Central

    Boddam-Whetham, Luke; Gul, Xaher; Al-Kobati, Eman; Gorter, Anna C

    2016-01-01

    ABSTRACT In conflict-affected states, vouchers have reduced barriers to reproductive health services and have enabled health programs to use targeted subsidies to increase uptake of specific health services. Vouchers can also be used to channel funds to public- and private-service providers and improve service quality. The Yamaan Foundation for Health and Social Development in Yemen and the Marie Stopes Society (MSS) in Pakistan—both working with Options Consultancy Services—have developed voucher programs that subsidize voluntary access to long-acting reversible contraceptives (LARCs) and permanent methods (PMs) of family planning in their respective fragile countries. The programs focus on LARCs and PMs because these methods are particularly difficult for poor women to access due to their cost and to provider biases against offering them. Using estimates of expected voluntary uptake of LARCs and PMs for 2014 based on contraceptive prevalence rates, and comparing these with uptake of LARCs and PMs through the voucher programs, we show the substantial increase in service utilization that vouchers can enable by contributing to an expanded method choice. In the governorate of Lahj, Yemen, vouchers for family planning led to an estimated 38% increase in 2014 over the expected use of LARCs and PMs (720 vs. 521 expected). We applied the same approach in 13 districts of Punjab, Khyber Pakhtunkhwa (KPK), and Sindh provinces in Pakistan. Our calculations suggest that vouchers enabled 10 times more women than expected to choose LARCs and PMs in 2014 in those areas of Pakistan (73,639 vs. 6,455 expected). Voucher programs can promote and maintain access to family planning services where existing health systems are hampered. Vouchers are a flexible financing approach that enable expansion of contraceptive choice and the inclusion of the private sector in service delivery to the poor. They can keep financial resources flowing where the public sector is prevented from

  17. Patterns of contraceptive use in Australia: analysis of the 2001 National Health Survey.

    PubMed

    Yusuf, Farhat; Siedlecky, Stefania

    2007-09-01

    The purpose of this paper is to review the patterns of contraceptive use in Australia, using data from a nationally representative sample of 5872 women aged 18 to 49. This survey was conducted by the Australian Bureau of Statistics in 2001 as part of the National Health Survey. Results of the analysis indicate that the oral contraceptive pill and condom were the two most frequently used methods. More than 76% of the respondents reported having ever used the pill. Over 23% of women were currently using condoms; of these 80% of the condom users used them for contraception - this included 36% who used condoms for both protection against infection and for contraception - and the remainder used them only for protection. Withdrawal was the third most popular non-surgical method up to age 40. Few women used IUDs, injections or diaphragms. Just over 3% of the respondents were using natural methods with the highest rate reported among those in their 30s. The 'morning-after pill' was reported mostly by women aged 18-24; however, there was no evidence to suggest that it was being used as a primary method of birth control. Contraceptive use declined in older women who turned to sterilization for themselves and/or their partners. Use of the contraceptive pill was somewhat higher among better-educated women, but lower among less-educated women and those from non-English-speaking backgrounds.

  18. Application of Lorenz curve to interpret concentration of contraception and fertility in a population.

    PubMed

    Ghanma, M A; Rider, R V; Sirageldin, I

    1984-01-01

    separate curves were plotted for the subgroups with attained desired family size and the subgroups without attained desired family size, it was apparent that the distribution of contraceptive practice was more uniform among those with attained desired family size than among the other 3 subgroups. A curve for the distribution of births was then plotted on the same graph. This curve was not a true application of the Lorenz Curve since it was based on the order of the subdivisions by birth rates. The resultant line approached the straight diagonal line and indicated that the distribution of births was fairly evenly distributed in the population. The uneven distribution of contraceptive practice and the uniform distribution of births suggests that contraceptive practice in this population is ineffective. This may be a characteristic of populations in the early stages of fertility control.

  19. The mechanism of action of hormonal contraceptives and intrauterine contraceptive devices.

    PubMed

    Rivera, R; Yacobson, I; Grimes, D

    1999-11-01

    Modern hormonal contraceptives and intrauterine contraceptive devices have multiple biologic effects. Some of them may be the primary mechanism of contraceptive action, whereas others are secondary. For combined oral contraceptives and progestin-only methods, the main mechanisms are ovulation inhibition and changes in the cervical mucus that inhibit sperm penetration. The hormonal methods, particularly the low-dose progestin-only products and emergency contraceptive pills, have effects on the endometrium that, theoretically, could affect implantation. However, no scientific evidence indicates that prevention of implantation actually results from the use of these methods. Once pregnancy begins, none of these methods has an abortifacient action. The precise mechanism of intrauterine contraceptive devices is unclear. Current evidence indicates they exert their primary effect before fertilization, reducing the opportunity of sperm to fertilize an ovum.

  20. Contraceptive failure in the United States.

    PubMed

    Trussell, James

    2011-05-01

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

  1. Feminism and the Moral Imperative for Contraception.

    PubMed

    Espey, Eve

    2015-08-01

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

  2. 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.

  3. Postpartum Care and Contraception in Obese Women.

    PubMed

    Maclean, Courtney C; Thompson, Ivana S

    2016-03-01

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

  4. Contraceptive failure in the United States

    PubMed Central

    Trussell, James

    2013-01-01

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

  5. [Contraception - where ultrasound is of significant support].

    PubMed

    Bajka, Michael

    2013-06-01

    The use of ultrasound is already routine in contraceptive procedures. One of the best examples is the transvaginal assessment of the IUD position. But ultrasound may improve safety and comfort to contraceptive procedures too, e. g. transabdominally guided IUD insertion may not only help avoiding perforation but also painful moments. In case of lost threads transabdominally guided IUD extraction might be completed successfully without any kind of anesthesia. Furthermore, a subcutaneous contraceptive implant, if not palpable, might be localized and extracted by transcutaneous ultrasound guidance during local anesthesia.

  6. Feminism and the Moral Imperative for Contraception.

    PubMed

    Espey, Eve

    2015-08-01

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

  7. 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

  8. A survey of contraception in five west European countries.

    PubMed

    Riphagen, F E; Lehert, P

    1989-01-01

    In 1984 and 1985, a survey was conducted of 7696 women aged 15-44 living in Italy, France, Great Britain, Spain and the Federal Republic of Germany. The aim of the study was to examine the use of contraceptive methods, the differences in contraceptive use, knowledge of fertility, communication about contraception, motives for choice and the perceptions held by women regarding contraceptive methods, particularly oral contraception. The results show important differences between the countries studied.

  9. What do Women Want? Experiences of Low-Income Women with Postpartum Contraception and Contraceptive Counseling

    PubMed Central

    Yee, Lynn M; Farner, Katherine C; King, Erin; Simon, Melissa A

    2016-01-01

    Background Contraceptive counseling can increase postpartum contraception use, yet the optimal method and timing for counseling are unknown. The objective was to investigate preferences of underserved pregnant and postpartum women regarding contraception use and counseling. Method Surveys regarding contraception experiences and perceptions of contraceptive counseling were conducted with 57 women age 18 and older who were postpartum or antepartum with a previous delivery within 5 years and receiving Medicaid-funded care at an academic medical center. Health literacy was assessed using REALM-7. Responses were analyzed using descriptive statistics. Results A majority of women reported unplanned pregnancies (78%). Women using contraception at the time of conception reported “not sure” (30%) and “taken wrong” (30%) as primary reasons for failure. Most subjects had at least a high school level of health literacy (88%), desired to use a postpartum contraceptive method (92%) and had a high self-reported understanding of that method (94%). Most women reported receiving counseling (91%) and stated that the best time for counseling was both before and after childbirth (84%). However, only 60% of subjects intended to use the method they were prescribed at discharge; reasons for changing included side effects (37%), desire for different contraception (23%) and too complicated of a method prescribed (17%). Conclusion Women perceived the best timing of contraceptive education to be both antepartum and postpartum. Despite a high frequency of prior contraceptive failure, self-reported understanding of the chosen postpartum contraceptive method was high. Contraception counseling should be tailored to a woman’s perceived needs, with such education occurring frequently and within the context of her health literacy. PMID:27294202

  10. New Zealand women's experience during their first year of Jadelle® contraceptive implant.

    PubMed

    Roke, Christine; Roberts, Helen; Whitehead, Anna

    2016-03-01

    INTRODUCTION Subsidisation of the levonorgestrel-releasing Jadelle® contraceptive implant in 2010 resulted in a rapid uptake. Clinicians had little prior experience of client satisfaction, side effect profile, and removal rate of this contraceptive method. AIM To obtain information on satisfaction, bleeding patterns, continuation rates and reasons for removal for New Zealand women during their first year of use of a subsidised contraceptive implant, Jadelle®. METHODS Women having a Jadelle® implant inserted in New Zealand Family Planning clinics were recruited to be followed up by phone, text or email at 1, 3, 6, 9 and 12 months. They were asked about their bleeding pattern, satisfaction and their views on benefits of, or problems with, implant use. RESULTS 252 women were recruited. The three common bleeding patterns in the cohort were regular periods, amenorrhoea and irregular bleeding. Eighteen percent had their implant removed within the first year with more than half of those being unhappy with their bleeding pattern. This was usually prolonged bleeding. Otherwise satisfaction rates were high throughout the year. DISCUSSION The majority of New Zealand women using Jadelle® were satisfied with this method of contraception during their first year of use. Implant removals were most likely to be related to prolonged bleeding. However the commonest bleeding pattern was regular periods. KEYWORDS Contraceptive implant; progestin; bleeding; satisfaction; continuation rate; reducing reproductive health inequalities.

  11. New Zealand women's experience during their first year of Jadelle® contraceptive implant.

    PubMed

    Roke, Christine; Roberts, Helen; Whitehead, Anna

    2016-03-01

    INTRODUCTION Subsidisation of the levonorgestrel-releasing Jadelle® contraceptive implant in 2010 resulted in a rapid uptake. Clinicians had little prior experience of client satisfaction, side effect profile, and removal rate of this contraceptive method. AIM To obtain information on satisfaction, bleeding patterns, continuation rates and reasons for removal for New Zealand women during their first year of use of a subsidised contraceptive implant, Jadelle®. METHODS Women having a Jadelle® implant inserted in New Zealand Family Planning clinics were recruited to be followed up by phone, text or email at 1, 3, 6, 9 and 12 months. They were asked about their bleeding pattern, satisfaction and their views on benefits of, or problems with, implant use. RESULTS 252 women were recruited. The three common bleeding patterns in the cohort were regular periods, amenorrhoea and irregular bleeding. Eighteen percent had their implant removed within the first year with more than half of those being unhappy with their bleeding pattern. This was usually prolonged bleeding. Otherwise satisfaction rates were high throughout the year. DISCUSSION The majority of New Zealand women using Jadelle® were satisfied with this method of contraception during their first year of use. Implant removals were most likely to be related to prolonged bleeding. However the commonest bleeding pattern was regular periods. KEYWORDS Contraceptive implant; progestin; bleeding; satisfaction; continuation rate; reducing reproductive health inequalities. PMID:27477370

  12. [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

  13. 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

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

    PubMed Central

    Dehlendorf, Christine; Krajewski, Colleen; Borrero, Sonya

    2014-01-01

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

  15. Contraceptive knowledge and attitudes of Austrian adolescents after mass media reports linking third-generation oral contraceptives with an increased risk of venous thromboembolism.

    PubMed

    Egarter, C; Strohmer, H; Lehner, R; Földy, M; Leitich, H; Berghammer, P

    1997-09-01

    We performed a representative survey to determine the level of knowledge of 1,010 Austrian adolescents aged 14 to 24 years about selected facts relating to the recent massive news coverage of the increase in the risk of venous thromboembolism in users of third-generation oral contraceptives and to assess the contraceptive behavior of this population. The overall use rate of oral contraceptives and condoms had increased significantly between 1991 and 1996. Sixty-six percent of the adolescents surveyed stated not having heard or read any media reports on oral contraceptives. Only 8% of those who had knew that most reports focused on the pill as a possible cause of venous thromboembolism, whereas the majority of respondents indicated that the media conveyed doubts regarding the health safety of oral contraceptives in general. Nearly half of adolescents were unable to define what a thrombosis was. Thus, although the mass media play an important role in transmitting medical information, the dissemination of practical, accurate advice on the risks of a drug and competent patient counseling is reserved for the health care professionals. PMID:9347204

  16. Male contraception: an overview of the potential target events.

    PubMed

    Tulsiani, Daulat R P; Abou-Haila, Aïda

    2008-06-01

    The contraceptive options available to men have not changed in several decades and are still limited to the non-surgical methods of the use of a condom, a timely withdrawal, or a surgical procedure that removes a segment of the vas deferens (vasectomy). The first two approaches have relatively higher failure rates whereas the last approach is largely irreversible and may not be suitable for younger men. Thus, providing a safe, effective and readily available contraception for men has remained an unfulfilled goal. In this article, we intend to review the current status of the research and development on male contraceptives. It is apparent that the scientific community in the past few decades has witnessed impressive progress in understanding the basics of male physiology, the knowledge necessary for developing new contraceptive methods for men. We will highlight various new and improved strategies for the regulation of fertility in males. The diverse approaches that are at various stages of development and/or in clinical trials include: 1) administration of hormones, herbal extracts or chemicals to suppress/arrest sperm production in the testes (spermatogenesis); 2) interference with the delivery of spermatozoa during ejaculation by targeted blockage of vas deferens with plugs or chemicals (polymers) that prevent flow of sperm through the vas duct; 3) active or passive immunization of males with well characterized antigens/antibodies which are intended to block sperm function; and 4) administration of site-directed antagonists to block specific sperm function(s) necessary for normal fertilization. All these approaches do not involve surgery and are reversible. Our intention is to discuss the current status of various approaches which show promising results in clinical trials, particularly in China and India, the world's most populous nations.

  17. Higher Prevalence and Awareness, but Lower Control Rate of Hypertension in Patients with Diabetes than General Population: The Fifth Korean National Health and Nutrition Examination Survey in 2011

    PubMed Central

    Ko, Seung-Hyun; Kwon, Hyuk-Sang; Kim, Dae Jung; Kim, Jae Hyeon; Kim, Nan Hee; Kim, Chul Sik; Song, Kee-Ho; Won, Jong Chul; Lim, Soo; Choi, Sung Hee; Han, Kyungdo

    2014-01-01

    Background We investigated the prevalence, awareness, treatment, and control rate of hypertension in Korean adults with diabetes using nationally representative data. Methods Using data of 5,105 adults from the fifth Korea National Health and Nutrition Examination Survey in 2011 (4,389 nondiabetes mellitus [non-DM]), 242 newly diagnosed with DM (new-DM), and 474 previously diagnosed with DM (known-DM), we analyzed the prevalence of hypertension (mean systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or use of antihypertensive medication) and control rate of hypertension (blood pressure [BP] <130/80 mm Hg). Results The prevalence of hypertension in diabetic adults was 54.6% (44.4% in new-DM and 62.6% in known-DM, P<0.0001 and P<0.0001, respectively) compared with non-DM adults (26.2%). Compared to non-DM, awareness (85.7%, P<0.001) and treatment (97.0%, P=0.020) rates were higher in known-DM, whereas no differences were found between new-DM and non-DM. Control rate among all hypertensive subjects was lower in new-DM (14.9%), compared to non-DM (35.1%, P<0.001) and known-DM (33.3%, P=0.004). Control rate among treated subjects was also lower in new-DM (25.2%), compared to non-DM (68.4%, P<0.0001) and known-DM (39.9%, P<0.0001). Conclusion Higher prevalence and low control rate of hypertension in adults with diabetes suggest that stringent efforts are needed to control BP in patients with diabetes, particularly in newly diagnosed diabetic patients. PMID:24627828

  18. Postcoital Contraception: Student Choices and Effectiveness.

    ERIC Educational Resources Information Center

    Schilling, Lee H.

    1984-01-01

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

  19. The natural way. A tropical contraceptive.

    PubMed

    1994-05-18

    It's not news for the women of the Indian subcontinent. For generations, they've been well aware that papaya and pregnancy don't mix. But now researchers at Britain's University of Sussex have proven the contraceptive qualities of the tropical fruit. "Women in Sri Lanka use papaya fruit as contraceptives because they are cheap and natural," says Tharmalingam Senthilomohan. "If they want to become pregnant, they simply avoid eating them." His findings: abortion can be induced by eating unripe papaya for three consecutive days. And daily consumption of ripe fruit can be an effective contraceptive. Senthilomohan has two theories on what gives papaya its contraceptive qualities. The tropical fruit contains an enzyme called papain which suppresses progesterone, a sex hormone needed to prepare the uterus for conception and to maintain the pregnancy. Another possibility is that papain, which can be used to tenderize meat, may break down a membrane vital to the development of the fetus. PMID:12288101

  20. What Are the Different Types of Contraception?

    MedlinePlus

    ... single use. Female condoms. These are thin, flexible plastic pouches. A portion of the condom is inserted ... blood clots. Contraceptive patch. This is a thin, plastic patch that sticks to the skin and releases ...

  1. 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.

  2. The quest for a herbal contraceptive.

    PubMed

    Chaudhury, R R

    1993-01-01

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

  3. Making good use of nature's contraceptive.

    PubMed

    Short, R

    1992-10-01

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

  4. [Selected aspects of oral contraception side effects].

    PubMed

    Wolski, Hubert

    2014-12-01

    The first hormonal pill was approved in the 60s of the twentieth century Since that time, oral contraception has been used worldwide by dozens of women due to its high availability as well as relative ease and safety of taking. The main side effects of oral contraception include elevated risk for venous thromboembolism (VTE). Estrogens increase the probability of VTE development, depending on the dose in medication, and third-generation progestins increase the risk of VTE development more than older-generation progestins. Also, the coexistence of hereditary thrombophilia increases the risk of VTE development in women using oral contraceptives. Other side effects include changes in the carbohydrate and lipid economy Progestins in oral contraceptives decrease HDL cholesterol levels but increase LDL cholesterol and total cholesterol levels. Additionally estrogens are a recognized mitogenic factor for the epithelium of the mammary gland, acting proliferative on the glandular tissue and in the same way influence on the increased risk of breast cancer development. Patients sometimes complain about some subjective side symptoms such as headache, mood changes, nausea, back pain, breast pain and swelling, as well as decreased libido. Some patients discontinue oral contraception due to fear of side effects or temporary ailments before con- sulting their doctor what may result in unintended pregnancy The aim of the following paper was to present most frequent side effects of oral contraception, ways of their moni- toring and diagnosis. PMID:25669065

  5. Contraception choices in women with underlying medical conditions.

    PubMed

    Bonnema, Rachel A; McNamara, Megan C; Spencer, Abby L

    2010-09-15

    Primary care physicians often prescribe contraceptives to women of reproductive age with comorbidities. Novel delivery systems (e.g., contraceptive patch, contraceptive ring, single-rod implantable device) may change traditional risk and benefit profiles in women with comorbidities. Effective contraceptive counseling requires an understanding of a woman's preferences and medical history, as well as the risks, benefits, adverse effects, and contraindications of each method. Noncontraceptive benefits of combined hormonal contraceptives, such as oral contraceptive pills, include regulated menses, decreased dysmenorrhea, and diminished premenstrual dysphoric disorder. Oral contraceptive pills may be used safely in women with a range of medical conditions, including well-controlled hypertension, uncomplicated diabetes mellitus, depression, and uncomplicated valvular heart disease. However, women older than 35 years who smoke should avoid oral contraceptive pills. Contraceptives containing estrogen, which can increase thrombotic risk, should be avoided in women with a history of venous thromboembolism, stroke, cardiovascular disease, or peripheral vascular disease. Progestin-only contraceptives are recommended for women with contraindications to estrogen. Depo-Provera, a long-acting injectable contraceptive, may be preferred in women with sickle cell disease because it reduces the frequency of painful crises. Because of the interaction between antiepileptics and oral contraceptive pills, Depo-Provera may also be considered in women with epilepsy. Implanon, the single-rod implantable contraceptive device, may reduce symptoms of dysmenorrhea. Mirena, the levonorgestrel-containing intrauterine contraceptive system, is an option for women with menorrhagia, endometriosis, or chronic pelvic pain. PMID:20842989

  6. Contraception choices in women with underlying medical conditions.

    PubMed

    Bonnema, Rachel A; McNamara, Megan C; Spencer, Abby L

    2010-09-15

    Primary care physicians often prescribe contraceptives to women of reproductive age with comorbidities. Novel delivery systems (e.g., contraceptive patch, contraceptive ring, single-rod implantable device) may change traditional risk and benefit profiles in women with comorbidities. Effective contraceptive counseling requires an understanding of a woman's preferences and medical history, as well as the risks, benefits, adverse effects, and contraindications of each method. Noncontraceptive benefits of combined hormonal contraceptives, such as oral contraceptive pills, include regulated menses, decreased dysmenorrhea, and diminished premenstrual dysphoric disorder. Oral contraceptive pills may be used safely in women with a range of medical conditions, including well-controlled hypertension, uncomplicated diabetes mellitus, depression, and uncomplicated valvular heart disease. However, women older than 35 years who smoke should avoid oral contraceptive pills. Contraceptives containing estrogen, which can increase thrombotic risk, should be avoided in women with a history of venous thromboembolism, stroke, cardiovascular disease, or peripheral vascular disease. Progestin-only contraceptives are recommended for women with contraindications to estrogen. Depo-Provera, a long-acting injectable contraceptive, may be preferred in women with sickle cell disease because it reduces the frequency of painful crises. Because of the interaction between antiepileptics and oral contraceptive pills, Depo-Provera may also be considered in women with epilepsy. Implanon, the single-rod implantable contraceptive device, may reduce symptoms of dysmenorrhea. Mirena, the levonorgestrel-containing intrauterine contraceptive system, is an option for women with menorrhagia, endometriosis, or chronic pelvic pain.

  7. Large-scale survey of rates of achieving targets for blood glucose, blood pressure, and lipids and prevalence of complications in type 2 diabetes (JDDM 40)

    PubMed Central

    Yokoyama, Hiroki; Oishi, Mariko; Takamura, Hiroshi; Yamasaki, Katsuya; Shirabe, Shin-ichiro; Uchida, Daigaku; Sugimoto, Hidekatsu; Kurihara, Yoshio; Araki, Shin-ichi; Maegawa, Hiroshi

    2016-01-01

    Objective The fact that population with type 2 diabetes mellitus and bodyweight of patients are increasing but diabetes care is improving makes it important to explore the up-to-date rates of achieving treatment targets and prevalence of complications. We investigated the prevalence of microvascular/macrovascular complications and rates of achieving treatment targets through a large-scale multicenter-based cohort. Research design and methods A cross-sectional nationwide survey was performed on 9956 subjects with type 2 diabetes mellitus who consecutively attended primary care clinics. The prevalence of nephropathy, retinopathy, neuropathy, and macrovascular complications and rates of achieving targets of glycated hemoglobin (HbA1c) <7.0%, blood pressure <130/80 mm Hg, and lipids of low-density/high-density lipoprotein cholesterol <3.1/≥1.0 mmol/L and non-high-density lipoprotein cholesterol <3.8 mmol/L were investigated. Results The rates of achieving targets for HbA1c, blood pressure, and lipids were 52.9%, 46.8% and 65.5%, respectively. The prevalence of microvascular complications was ∼28% each, 6.4% of which had all microvascular complications, while that of macrovascular complications was 12.6%. With an increasing duration of diabetes, the rate of achieving target HbA1c decreased and the prevalence of each complication increased despite increased use of diabetes medication. The prevalence of each complication decreased according to the number achieving the 3 treatment targets and was lower in subjects without macrovascular complications than those with. Adjustments for considerable covariates exhibited that each complication was closely inter-related, and the achievement of each target was significantly associated with being free of each complication. Conclusions Almost half of the subjects examined did not meet the recommended targets. The risk of each complication was significantly affected by 1 on-target treatment (inversely) and the

  8. [The obese woman: pregnancy and contraception].

    PubMed

    Seffert, P

    1985-10-01

    Obesity is a risk factor for women in both pregnancy and contraception. Obesity per se does not cause sterility, but problems in gonadotropic function can arise during periods of rapid weight gain in bulimic episodes. Dysovulation is more common in such cases than amenorrhea. In established obesity, anovulation may occur, as demonstrated by the temperature curve and hormonal levels, but it is usually due to other factors such as ovarian polycystic syndrome or Cushing's syndrome. The main problems of obesity during pregnancy are carbohydrate metabolic disorders and hypertension. In 1 study, hypertension was found in 42.4% of pregnancies of obese women vs. 5.84% in controls; 22% of cases were severe, with blood pressure over 160/100. Carbohydrate metabolic difficulties were found in 11.8% of obese subjects vs. 1.2% of controls. The main consequence of maternal obesity on the child is macrosomy; occurring in 21.3% of births vs. 5.8% in controls. 5.1% of births to obese women are postmature vs. .7% in controls. The rate of cesareans for obese women is high. Improved fetal prognosis in pregnancies of obese women requires increased clinical surveillance for signs of hypertension or excessive weight gain and laboratory monitoring of glucose metabolism every month or even every 2 weeks. A sonogram should be done to detect macrosomy. A careful diet of 1200-1500 calories per day is recommended. 40% should be protein and 30% lipid. Rapid-absorption sugars should be excluded. Oral contraceptives appear to cause weight gain because estrogen stimulates the appetite and progestins have an anabolizing action. If weight gain exceeds 3 kg, a low dose pill and a restrictive diet should be recommended. OCs should be terminated if weight gain continues, and anomalies of glucose or lipid metabolism should be ruled out. Obesity constitutes a relative contraindication for use of combined OCs. Combined OCs may aggravate the obesity. Obesity on the other hand is a risk factor for

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

    ERIC Educational Resources Information Center

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

    2010-01-01

    Background: Little is known about how young people communicate about initiating intercourse. Purpose: This study was designed to gauge the prevalence of implied versus verbal consent at first intercourse in a U.S. college population, assess effects of consent type on contraceptive use, and explore the influences of gender, race and other factors.…

  10. 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

  11. [Contraceptive development for the future].

    PubMed

    Zatuchni, G I

    1984-06-01

    This article provides background on worldwide contraceptive usage as an introduction to its main topic, new methods of fertility regulation now under development in terms of their intervention in specific reproductive processes. A large number of chemical compounds and steroidal or nonsteroidal pharmacologic agents have been shown to interfere directly of indirectly with the processes of spermatogenesis, but most are associated with undesirable side effects. Nitrofuranes, alpha-chlorohydrine and othr chlorinated sugars, cyproterone acetate, estrogen, progestins, testosterone alone or in combination with other hormonal agents, and the cotton seed derivative gossypol have all been tested. Although research on some of them continues, questions questions of side effects, toxicity, and reversibility have arisen. Luteinizing hormone releasing hormone analogs and especially antagonists offer promise as a male contraceptive use in conjunction with testosterone, but further research on efficacy and reversibility is needed. Percutaneous vas occlusion using chemical substances including a mixture of ethannol and formaldehyde, and occlusion of the vas by electrocautery are norsurgical techniques of vas occlusion that are expected to be more acceptable to men than current surgical techniques. Various removable devices for vas occlusion have been studies, such as silicone or nylon threads, valves of different kinds, polymers, and threads of metal, especially copper, but thus far all have posed serious technical problems. Methods under development which block sperm transport in the female genital tract include enzyme sperm inhibitors and long-acting steroids, spermicides, improved vaginal sponges, disposable diaphragms impregnated with spermicide, vaginal rings, water soluble spermicidal condoms, a latex cervical cap kept in place by suction, an intracervical device that would liberate progesterone, transcervical approaches to sterilization by occlusion of the salpingo

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

    ERIC Educational Resources Information Center

    Ryan, Suzanne; Franzetta, Kerry; Manlove, Jennifer

    2007-01-01

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

  13. Factors associated with contraceptive use and intention to use contraceptives among married women in Ethiopia.

    PubMed

    Tiruneh, Fentanesh Nibret; Chuang, Kun-Yang; Ntenda, Peter A M; Chuang, Ying-Chih

    2016-01-01

    Family planning has improved the well-being of families by preventing high-risk pregnancies and abortions and reducing unplanned pregnancies. However, the effectiveness of family planning efforts has not been consistent across countries. This study examined factors associated with contraceptive use among married women in Ethiopia. Data were from the 2011 Ethiopian Demographic and Health Survey. The sample comprised 10,204 married women (aged 15-49 years). Logistic regression models were used to analyze the data. Among married women in Ethiopia, 29.2% used contraceptive methods. About 44.1% of women who were not current users of contraceptives reported that they intended to use contraceptives in the future. Age at first marriage, being educated, number of living children, exposure to mass media, being employed, having educated partners, and having been informed about contraceptive use at health facilities were positively associated with current contraceptive use. By contrast, older age, a rural resident, or Muslim; belonging to the Afar or Somali ethnic groups; desiring numerous children; having husbands who desired additional children; and abortion experience were negatively associated with current contraceptive use. Our findings indicated that improving education, providing employment opportunities for women, and providing training to family planning providers are essential to increasing contraceptive use. PMID:26212154

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

    PubMed Central

    Yee, Lynn M.; Simon, Melissa

    2010-01-01

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

  15. Public knowledge and perceptions about unplanned pregnancy and contraception in three countries.

    PubMed

    Delbanco, S; Lundy, J; Hoff, T; Parker, M; Smith, M D

    1997-01-01

    A 1994-1995 survey of men and women aged 18-44 in the United States, Canada and the Netherlands revealed considerable differences in public knowledge and perceptions about unplanned pregnancy and contraception. The proportion who believe that unplanned pregnancy is a "very big problem" is 60% in the United States, 36% in Canada and 6% in the Netherlands. Americans are more likely than their Canadian or Dutch counterparts to cite societal problems as significant factors in the rate of unplanned pregnancy; higher proportions of Americans also cite the cost of contraceptives (52% vs. 46% of Canadians and 34% of Dutch men and women) and an inability to obtain methods (66%, 51% and 33%, respectively). In all three countries, adults are generally well informed about the relative effectiveness of commonly used contraceptives, but Americans are more skeptical about method safety and effectiveness. For example, 17% think the pill is "very safe," compared with 21% of Canadians and 40% of the Dutch; and whereas 64% of Americans consider the pill "very effective," 73% of Canadians and 90% of Dutch men and women give it this rating. Health care professionals are the most frequently cited source of contraceptive information, but only 51-63% of adults have ever discussed contraception with such a practitioner. PMID:9099570

  16. Japan's fertility: effects of contraception and induced abortion after World War II.

    PubMed

    Tsuya, N O

    1986-11-01

    This report studies the effects of contraception and abortion on crude birth rate (CBR) and total fertility rate (TFR) in Japan from 1947-1980. The CBR declined from 34.3 in 1947 to 17.3 in 1957, and the TFR from 4.5 to 2.0 in the same period. Both stabilized (CBR in the range of 17.0 to 19.0 and TFR at 2.0 to 2.1) between 1957 and 1973. This dramatic decline in fertility was initiated under the serious socioeconomic difficulties of post-World War II Japan. At the onset of the postwar fertility decline, fertility within marriage was controlled most strongly by induced abortion, and to a lesser extent, lactation and contraception. During the period of stable low fertility (1960-1980) the effect of abortion decreased and the effect of contraception increased. KAP surveys show that in the late 1970's more than 75% of contraceptive users in Japan employed the condom, while condom use in other Asian countries is generally very low. A shift from traditional to modern methods of contraception is unlikely to alter the already low level of fertility in Japan but would have considerable social, medical, and economic impact.

  17. Early Impact Of The Affordable Care Act On Oral Contraceptive Cost Sharing, Discontinuation, And Nonadherence.

    PubMed

    Pace, Lydia E; Dusetzina, Stacie B; Keating, Nancy L

    2016-09-01

    The oral contraceptive pill is the contraceptive method most commonly used by US women, but inconsistent use of the pill is a contributor to high rates of unintended pregnancy. The relationship between consumer cost sharing and consistent use of the pill is not well understood, and the impact of the elimination of cost sharing for oral contraceptive pills in a mandate in the Affordable Care Act (ACA) is not yet known. We analyzed insurance claims for 635,075 women with employer-sponsored insurance who were initiating use of the pill, to examine rates of discontinuation and nonadherence, their relationship with cost sharing, and trends before and during the first year after implementation of the ACA mandate. We found that cost sharing for oral contraceptives decreased markedly following implementation, more significantly for generic than for brand-name versions. Higher copays were associated with greater discontinuation of and nonadherence to generic pills than was the case with zero copayments. Discontinuation of the use of generic or brand-name pills decreased slightly but significantly following ACA implementation, as did nonadherence to brand-name pills. Our findings suggest a modest early impact of the ACA on improving consistent use of oral contraceptives among women initiating their use.

  18. Early Impact Of The Affordable Care Act On Oral Contraceptive Cost Sharing, Discontinuation, And Nonadherence.

    PubMed

    Pace, Lydia E; Dusetzina, Stacie B; Keating, Nancy L

    2016-09-01

    The oral contraceptive pill is the contraceptive method most commonly used by US women, but inconsistent use of the pill is a contributor to high rates of unintended pregnancy. The relationship between consumer cost sharing and consistent use of the pill is not well understood, and the impact of the elimination of cost sharing for oral contraceptive pills in a mandate in the Affordable Care Act (ACA) is not yet known. We analyzed insurance claims for 635,075 women with employer-sponsored insurance who were initiating use of the pill, to examine rates of discontinuation and nonadherence, their relationship with cost sharing, and trends before and during the first year after implementation of the ACA mandate. We found that cost sharing for oral contraceptives decreased markedly following implementation, more significantly for generic than for brand-name versions. Higher copays were associated with greater discontinuation of and nonadherence to generic pills than was the case with zero copayments. Discontinuation of the use of generic or brand-name pills decreased slightly but significantly following ACA implementation, as did nonadherence to brand-name pills. Our findings suggest a modest early impact of the ACA on improving consistent use of oral contraceptives among women initiating their use. PMID:27605641

  19. Emergency Contraception: Do Your Patients Have a Plan B?

    PubMed

    Bullock, Holly; Salcedo, Jennifer

    2015-12-01

    Emergency contraception is used after unprotected sex, inadequately protected sex, or sexual assault to reduce the risk of pregnancy. Of emergency contraceptive methods available in the United States, the copper intrauterine device has the highest efficacy, followed by ulipristal acetate, levonorgestrel-containing emergency contraceptive pills, and the Yuzpe method. However, access to the most effective methods is limited. Although advanced prescription of emergency contraceptive pills and counseling on emergency contraception to all reproductive-aged women is recommended, women should be advised to contact their health care providers after taking emergency contraceptive pills to discuss possible copper intrauterine device placement and other follow-up.

  20. Non-hormonal male contraception: A review and development of an Eppin based contraceptive.

    PubMed

    O'Rand, Michael G; Silva, Erick J R; Hamil, Katherine G

    2016-01-01

    Developing a non-hormonal male contraceptive requires identifying and characterizing an appropriate target and demonstrating its essential role in reproduction. Here we review the development of male contraceptive targets and the current therapeutic agents under consideration. In addition, the development of EPPIN as a target for contraception is reviewed. EPPIN is a well characterized surface protein on human spermatozoa that has an essential function in primate reproduction. EPPIN is discussed as an example of target development, testing in non-human primates, and the search for small organic compounds that mimic contraceptive antibodies; binding EPPIN and blocking sperm motility. Although many hurdles remain before the success of a non-hormonal male contraceptive, continued persistence should yield a marketable product.

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

    PubMed

    Sedgh, Gilda; Hussain, Rubina

    2014-06-01

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

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

    PubMed

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

    2016-01-01

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

  3. Oral contraceptives and birth defects.

    PubMed

    Smithells, R W

    1981-06-01

    Although OCs (oral contraceptives) are not designed to be taken during pregnancy, in Europe and the U.S. they are taken by 2-5% of women in early pregnancy and by 1/4-1/3 of women 3-4 months prior to conception. The effects of OCs on folic acid and other vitamin metabolism are well known and provide a theoretical basis for possible teratogenicity, even when stopped prior to conception. Both hormone support therapy for threatened abortions and hormonal pregnancy tests have been abandoned in recent years, the first because it proved inefficacious, the second because there are better alternatives available. In neither of these cases were sex hormones shown to be teratogenic. Most cohort (prospective) and many case-control (retrospective) studies have shown no association between OC use and birth defects. Case-control methodology can be criticized because of recall bias and because of the difficulty of choosing entirely matched controls. Several studies have shown OC users to have characteristics slightly different from the general population, e.g., they are younger, more often unmarried, and are more likely to smoke during pregnancy. Any of these characteristics might influence the occurrence of teratogenicity. It is impossible to prove that OCs constitute a low-level teratogen. The author considers them nonteratogenic.

  4. [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.

  5. Latin America's contributions to contraceptive development.

    PubMed

    Coutinho, E M

    1993-08-01

    The contributions of Latin Americans to contraceptive research began in 1951 when the Mexican chemist, Miramontes, invented norethisterone (norethindrone). Early studies on the use of this drug with ethinyl estradiol in an oral contraceptive (OC) pill were conducted in Puerto Rico. Publication of these studies was the second milestone in contraceptive development. While the leaders of this work, Pincus and Rock, were widely acknowledged, the many doctors who carried out the trials and reported their observations have been forgotten. The next milestone was the introduction of the estrogen-free OC by Martinez-Manautou and his collaborators in 1966. That same year Coutinho, de Souza, and Csapo reported on the contraceptive effect of medroxyprogesterone acetate (MPA) based on work done in Brazil. Also from Brazil came the proposal to use MPA in combination with estrogen in a monthly contraceptive injectable. The development of Depo-Provera and other injectables also took place mostly in Latin America. The first norgestrel-containing pill was also developed in Brazil, and successful efforts to reduce the dosage to a half tablet prefigured the development of low-dose OCs. Norplant was developed in Brazil, with the first clinical trails taking place in Chile. Other proposals followed during the late 1970s, including efforts to develop a male contraceptive. The first clinical trials with gossypol outside of China took place in Brazil. A Latino, Zipper, also proposed the use of copper in IUDs which increased the acceptability of this method. In addition to the researchers cited here, many others have contributed decisively to contraceptive development. The fact that they are not receiving the recognition they deserve is disappointing since the only real reward for their dedicated work would be recognition of their results.

  6. Knowledge and attitudes of Latin American obstetricians and gynecologists regarding intrauterine contraceptives

    PubMed Central

    Bahamondes, Luis; Makuch, Maria Y; Monteiro, Ilza; Marin, Victor; Lynen, Richard

    2015-01-01

    Background Intrauterine contraceptives (IUCs), including the copper intrauterine device and the levonorgestrel-releasing intrauterine system (LNG-IUS), are among the reversible contraceptive methods with high effectiveness. However, use is low in many settings, including some Latin American countries, mainly due to the influences of myths, fears, and negative attitudes, not only of users and potential users, but also of different cadres of health care professionals. The purpose of this study was to assess the knowledge and attitudes of a group of Latin American obstetricians and gynecologists regarding IUCs. Methods A survey was conducted during a scientific meeting organized in Chile in 2014 to present and discuss updated information about contraception. Obstetricians and gynecologists from 12 Latin American countries, who reported that they provide daily contraception services in both the public and private sectors, participated in the meeting. Participants who agreed to take part in the survey responded to a multiple-choice questionnaire on issues regarding knowledge, use, and attitudes about IUCs. Results Of the 210 obstetricians and gynecologists participating in the meeting, the respondents to each question varied from 168 (80.0%) to 205 (97.6%). Almost 50% recognized that the failure rate of combined oral contraceptives, patches, and vaginal rings is 8%–10%. Furthermore, 10% of the participants did not recognize the high contraceptive effectiveness of long-acting reversible contraceptive methods. Additionally, almost 80% of the respondents answered that they did not offer IUCs to nulligravidas and almost 10% did not offer IUCs to adolescents, albeit almost 90% of the respondents reported that nulligravidas are candidates for an LNG-IUS. Conclusion Some deficiencies and contradictions in terms of knowledge and attitudes were identified from the answers of the Latin American obstetricians and gynecologists who participated in the survey. The knowledge and

  7. Designed Chemical Intervention with Thiols for Prophylactic Contraception.

    PubMed

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

    2013-01-01

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

  8. How common are common mental disorders? Evidence that lifetime prevalence rates are doubled by prospective versus retrospective ascertainment

    PubMed Central

    Moffitt, T. E.; Caspi, A.; Taylor, A.; Kokaua, J.; Milne, B. J.; Polanczyk, G.; Poulton, R.

    2013-01-01

    Background Most information about the lifetime prevalence of mental disorders comes from retrospective surveys, but how much these surveys have undercounted due to recall failure is unknown. We compared results from a prospective study with those from retrospective studies. Method The representative 1972–1973 Dunedin New Zealand birth cohort (n=1037) was followed to age 32 years with 96% retention, and compared to the national New Zealand Mental Health Survey (NZMHS) and two US National Comorbidity Surveys (NCS and NCS-R). Measures were research diagnoses of anxiety, depression, alcohol dependence and cannabis dependence from ages 18 to 32 years. Results The prevalence of lifetime disorder to age 32 was approximately doubled in prospective as compared to retrospective data for all four disorder types. Moreover, across disorders, prospective measurement yielded a mean past-year-to-lifetime ratio of 38% whereas retrospective measurement yielded higher mean past-year-to-lifetime ratios of 57% (NZMHS, NCS-R) and 65% (NCS). Conclusions Prospective longitudinal studies complement retrospective surveys by providing unique information about lifetime prevalence. The experience of at least one episode of DSM-defined disorder during a lifetime may be far more common in the population than previously thought. Research should ask what this means for etiological theory, construct validity of the DSM approach, public perception of stigma, estimates of the burden of disease and public health policy. PMID:19719899

  9. Canadian Contraception Consensus (Part 2 of 4).

    PubMed

    Black, Amanda; Guilbert, Edith; Costescu, Dustin; Dunn, Sheila; Fisher, William; Kives, Sari; Mirosh, Melissa; Norman, Wendy V; Pymar, Helen; Reid, Robert; Roy, Geneviève; Varto, Hannah; Waddington, Ashley; Wagner, Marie-Soleil; Whelan, Anne Marie; Ferguson, Carrie; Fortin, Claude; Kielly, Maria; Mansouri, Shireen; Todd, Nicole

    2015-11-01

    Objectif : Fournir des lignes directrices aux fournisseurs de soins quant à l’utilisation de modes de contraception pour la prévention de la grossesse et quant à la promotion d’une sexualité saine. Issues : Orientation des praticiens canadiens en ce qui concerne l’efficacité globale, le mécanisme d’action, les indications, les contre-indications, les avantages n’étant pas liés à la contraception, les effets indésirables, les risques et le protocole de mise en œuvre des modes de contraception abordés; planification familiale dans le contexte de la santé sexuelle et du bien-être général; méthodes de counseling en matière de contraception; et accessibilité et disponibilité des modes de contraception abordés au Canada. Résultats : La littérature publiée a été récupérée par l’intermédiaire de recherches menées dans MEDLINE et The Cochrane Library entre janvier 1994 et janvier 2015 au moyen d’un vocabulaire contrôlé (p. ex. contraception, sexuality, sexual health) et de mots clés (p. ex. contraception, family planning, hormonal contraception, emergency contraception) appropriés. Les résultats ont été restreints aux analyses systématiques, aux études observationnelles et aux essais comparatifs randomisés / essais cliniques comparatifs publiés en anglais entre janvier 1994 et janvier 2015. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu’en juin 2015. La littérature grise (non publiée) a été identifiée par l’intermédiaire de recherches menées dans les sites Web d’organismes s’intéressant à l’évaluation des technologies dans le domaine de la santé et d’organismes connexes, dans des collections de directives cliniques, dans des registres d’essais cliniques et auprès de sociétés de spécialité médicale nationales et internationales. Valeurs : La qualité des résultats a été évaluée au moyen des critères décrits dans

  10. Canadian Contraception Consensus (Part 1 of 4).

    PubMed

    Black, Amanda; Guilbert, Edith; Costescu, Dustin; Dunn, Sheila; Fisher, William; Kives, Sari; Mirosh, Melissa; Norman, Wendy V; Pymar, Helen; Reid, Robert; Roy, Geneviève; Varto, Hannah; Waddington, Ashley; Wagner, Marie-Soleil; Whelan, Anne Marie; Ferguson, Carrie; Fortin, Claude; Kielly, Maria; Mansouri, Shireen; Todd, Nicole

    2015-10-01

    Objectif : Fournir des lignes directrices aux fournisseurs de soins quant à l’utilisation de modes de contraception pour la prévention de la grossesse et quant à la promotion d’une sexualité saine. Issues : Orientation des praticiens canadiens en ce qui concerne l’efficacité globale, le mécanisme d’action, les indications, les contre-indications, les avantages n’étant pas liés à la contraception, les effets indésirables, les risques et le protocole de mise en œuvre des modes de contraception abordés; planification familiale dans le contexte de la santé sexuelle et du bien-être général; méthodes de counseling en matière de contraception; et accessibilité et disponibilité des modes de contraception abordés au Canada. Résultats : La littérature publiée a été récupérée par l’intermédiaire de recherches menées dans MEDLINE et The Cochrane Library entre janvier 1994 et janvier 2015 au moyen d’un vocabulaire contrôlé (p. ex. contraception, sexuality, sexual health) et de mots clés (p. ex. contraception, family planning, hormonal contraception, emergency contraception) appropriés. Les résultats ont été restreints aux analyses systématiques, aux études observationnelles et aux essais comparatifs randomisés / essais cliniques comparatifs publiés en anglais entre janvier 1994 et janvier 2015. Les recherches ont été mises à jour de façon régulière et intégrées à la directive clinique jusqu’en juin 2015. La littérature grise (non publiée) a été identifiée par l’intermédiaire de recherches menées dans les sites Web d’organismes s’intéressant à l’évaluation des technologies dans le domaine de la santé et d’organismes connexes, dans des collections de directives cliniques, dans des registres d’essais cliniques et auprès de sociétés de spécialité médicale nationales et internationales. Valeurs : La qualité des résultats a été évaluée au moyen des critères décrits dans

  11. Adolescent sexuality, contraceptive health and STD.

    PubMed

    Irmak, Y; Jainudeen, M R; Irvin, R P

    1986-10-01

    Major topics addressed by this article on adolescent sexuality include adolescent festivals, adolescent reproductive psychophysiology, contraception for adolescents, the World Federation of Contraception and Health, sexually transmitted diseases, and recommendations for research. The purpose of adolescent festivals is to increase communication between young people and their parents on subjects such as sexuality. Of particular concern is the traumatic emotional, physical, and financial impact of adolescent pregnancy, both in developed and developing countries. Contraceptive methods considered to be most appropriate for use in developing countries are injectable Depo-Provera and the Norplant contraceptive implant system. To reduce the problem of adolescent pregnancy, television programs need to portray responsible sexuality, family responsibility and involvement must be strengthended, funds for education and prevention programs should be increased, and there must be more intraprofessional collaboration. The World Federation of Contraception and Health, a nonprofit multicenter institution, has been created to make recommendations on how current resources can be utilized to address problems of adolescent sexuality. Adolescent clubs are being set up to provide adolescents and their families with computer support and information. Another concern is the spread of sexually transmitted diseases that cause infections in the genitourinary tract and threaten to impair future fertility. The incidence of diseases such as chlamydia trachomatis and nongonococcal urethritis is especially high in teenagers. Needed in the future are more multicenter studies conducted by microbiologists, pathophysiologists, family planning experts, epidemiologists, venereologists, gynecologists, obstetricians, and dermatologists on the many aspects of adolescent sexuality.

  12. Anti-Toxoplasma Antibody Prevalence, Primary Infection Rate, and Risk Factors in a Study of Toxoplasmosis in 4,466 Pregnant Women in Japan

    PubMed Central

    Noda, Shunichi; Hanaoka, Masachi; Nakayama, Hirotoshi; Hojo, Satoshi; Kakinoki, Shigeko; Nakata, Maki; Yasuda, Takashi; Ikenoue, Tsuyomu; Kojima, Toshiyuki

    2012-01-01

    Toxoplasmosis is a zoonosis caused by infection with Toxoplasma gondii and is prevalent worldwide under various climatic conditions. It is usually asymptomatic, but infection in pregnant women can pose serious health problems for the fetus. However, epidemiological information regarding toxoplasmosis in Japanese pregnant women is limited. This study aimed to determine the prevalence of anti-Toxoplasma antibodies, the primary infection rate, and the risk factors for toxoplasmosis in Japanese pregnant women. We measured anti-Toxoplasma antibody titers in 4,466 pregnant women over a period of 7.5 years and simultaneously conducted interviews to identify the risk factors for toxoplasmosis. The overall prevalence of anti-Toxoplasma antibodies was 10.3%, and it was significantly higher in women aged above 35 years. The