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PubMed1994

Contraceptive methods and risk of pelvic endometriosis.

The relation between contraceptive methods and risk of pelvic endometriosis has been analyzed in a case-control study. Cases were 376 women with laparoscopically or laparotomically confirmed pelvic endometriosis admitted to a network of Obstetrics and Gynecology Clinics in Lombardy, Northern Italy. Controls were 522 women admitted for acute non-gynecological and non-obstetrics conditions to the same hospitals where cases had been identified. A total 153 women (40.3%) out of the 377 cases and 154 (29.7%) out of the 522 controls reported ever oral contraceptive (OC) use: the corresponding relative risk (RR) was 1.6 (95% confidence interval, CI, 1.2-2.2). The risk was restricted to ex-OC users (RR 1.7, 95% CI 1.3-2.4), the estimated RR for current users being 0.9 (95% CI 0.5-1.9). No clear relation emerged with duration, recency and latency of OC use and risk of endometriosis. In comparison with never IUD users, the risk for ever users was 1.3 (95% CI 0.6-2.8), and no clear relation emerged with duration of use. Likewise, no association was observed between barrier method of contraception and risk of endometriosis (RR ever vs never users 0.5, 95% CI 0.3-1.4). The role of selection and other biases should be considered in the interpretation of epidemiological data on the role of OC on the risk of endometriosis.

Adult↗
PubMedDate not supplied

Vanguard family planning acceptors in Senegal.

This study examines contraceptive use among clients at the three clinics providing family planning services in Dakar, Senegal in early 1983. Most clients first became interested in family planning following the birth of a child, and most are interested in spacing future pregnancies, although one-third state that they want no more children. The clinic itself was found to be an important determinant of the type of contraceptive used, with only the government-operated clinic providing a balance between IUDs, oral contraceptives, and barrier methods. Nearly half of the clients interviewed said that a lack of knowledge about contraception is the reason for the low contraceptive prevalence rates among Senegalese women; another frequently cited reason was the opposition of the husband. Most clients reported the broadcast media to be the best means of providing family planning information to potential acceptors.

Contraceptive Devices, Male↗
PubMed1989

Contraceptive practices of patients referred for colposcopy with an abnormal cervical smear.

This study examined the contraceptive practices of 100 patients referred for colposcopy because of an abnormal cervical smear. At presentation 49% were using oral contraception but 94% had taken the pill at some time. Eight of the 10 patients using barrier methods were relying on condoms: in at least seven of the eight cases an abnormal cervical smear preceded condom usage. Thus, the method of contraception used when cervical neoplasia develops may differ from the method used when the patient presents for colposcopy. Although consistent with previous studies suggesting that the incidence of cervical neoplasia is increased in women using oral contraception, the risk of neoplasia is more likely to be explained by the degree of exposure of the cervix to an infectious carcinogen or to the immunosuppressive effects of seminal plasma. We suggest that future studies of the epidemiology and natural history of cervical neoplasia should include a detailed contraceptive history.

Adolescent↗
PubMedDate not supplied

Contraceptive options for the 1990s.

Estrogen-progestin combination oral contraceptives (COCs) are well tolerated, offer high reliability, convenience, and ready availability, but require strict adherence to dosing guidelines. Progesterones work by inhibiting ovulation, thickening cervical mucus, and/or suppressing endometrial growth. An FDA advisory committee has concluded that the benefits outweigh the risks of the mifepristone/misoprostol regimen for use in the United States. IUDs are a good choice for women who want to avoid the inconvenience of barrier methods and who cannot use other forms of contraception. Barrier contraceptives offer low cost and easy availability, but lower effectiveness than other methods.

Condoms↗
PubMed1986

Weight gain in adolescent and young adult oral contraceptive users.

This study analyzed weight gain as a side effect of oral contraceptive use in teens and young adults. A retrospective chart review from 1978 to 1983 was conducted at two family planning clinics. Weight gain over 12 months was compared between females starting oral contraceptive pills and a control group using an IUD or a barrier method. One-hundred thirty-eight charts were included in the oral contraceptive group and 35 in the control group. There was no significant difference between the oral contraceptive group and control group in initial weight and weight after one year of use. Distribution of weight was also similar. There were no significant blood pressure changes. In the oral contraceptive group only five (3.7%) users listed weight gain as a side effect. The results suggest that for many young women who use oral contraceptive pills there is no greater risk of weight gain than for other sexually active young females.

Adolescent↗
PubMed2000

Use of female controlled microbicidal products for HIV risk reduction.

Many over-the-counter microbicidal contraceptive methods reduce the risk of acquiring sexually transmitted diseases. This pilot project compared the use of female controlled barrier methods in an extremely high-risk population of low-income drug abusing women following an intervention designed to promote HIV risk reduction and barrier use. An HIV transmission risk reduction interactive intervention emphasizing self-esteem, assertiveness and sexual negotiation was offered to 41 drug dependent women. Participants were randomly assigned to one of two conditions, a male and female condom condition or a male and female condom plus N-9 products (vaginal suppositories, film, gel) condition. Results from the three-month follow-up period suggest that there may be a synergistic effect of availability of multiple protective methods on the overall rate of protective behaviours. The use of the male condom for penile/vaginal sex increased from 19% at study entry to 27% during the three-month follow-up period. The total protected sexual episode rate, calculated to include use of the other protective barriers distributed, was 60%. Thus, the condom use rate was not found to decrease because of the availability of alternative methods of protection. Future research should address the use of microbicidal products to empower women to prevent STD/HIV transmission.

Adult↗
PubMed1997

Condom and nonoxynol-9 use and the incidence of HIV infection in serodiscordant couples in Zambia.

We aimed to measure the effectiveness of latex condoms and of nonoxynol-9 [N-9] spermicides, in preventing HIV transmission in heterosexual serodiscordant couples in Lusaka. Each couple was examined at clinic visits scheduled at 3-month intervals for one year or more per couple, or until seroconversion or discontinuation. Couples were given condoms and their choice of 3 N-9 products and advised to use both at every intercourse. Sexual exposure was ascertained from coital logs that recorded coitus and barrier method use. HIV serological testing was done at each clinic visit (ELISA and Western blot if positive). One hundred and ten discordant couples were followed for a mean of 17.6 months. Seventy-eight per cent of coital episodes were protected by condoms, 85% by spermicides and 6.4% were unprotected. Fourteen seroconversions occurred (8.7 infections per 100 couple-years [c-y]). The rate was higher among seronegative men than seronegative women. Among couples who reported using condoms at every intercourse the infection rate was 2.3/100 c-y, compared with 10.7/100 c-y among couples using condoms less consistently (rate ratio [RR] 0.2; 95% confidence interval [CI] 0-1.6). Among couples who reported using N-9 at every intercourse, the seroconversion rate was 6.9/100 c-y; among couples who reported less than full-time N-9 use, the rate was 8.9/100 c-y (RR 0.8; 95% CI 0.2-2.8). Among the subset of female seronegatives, the N-9 RR was 0.5 (95% CI 0.1-3.8). But when we calculated HIV rates according to N-9 consistency in coital acts when condoms were not used, there was no evidence of protection with higher N-9 use. Consistent use of latex condoms reduces the incidence of HIV infection, but the association between N-9 spermicides and HIV is less clear. The current study could not provide compelling data on the impact of N-9 spermicide use on risk of HIV infection. The study's small size, as well as the consistency of concurrent condom use, limited our inferences. Available spermicide products must be studied further.

Adolescent↗
PubMed1980

Preliminary testing of the contraceptive collagen sponge.

The results of 3 years of developing the collagen sponge as an intravaginal contraceptive are presented. Postcoital tests were used to evaluate the efficacy of the sponge as a mechanical barrier. Results with the collagen sponge alone were compared to those of the sponge with spermicidal cream or spermicidal solution (acid buffer and zinc) and of spermicidal cream alone. The presence of any motile spermatozoa in the cervical mucus was considered a failure of the barrier method. The collagen sponge alone or with acid and zinc and spermicidal cream alone had failure rates of 22, 20, and 14%, respectively, whereas the collagen sponge with spermicidal cream had a 6% failure rate. The authors conclude that the combination of a mechanical and a chemical barrier is a more effective contraceptive method than a mechanical barrier or chemical agent alone.

Adolescent↗
PubMed1996

Gender differences in crack users who are research volunteers.

This study compared gender differences in a non-treatment sample of crack cocaine users interested in participating in a research study on addiction. Data was collected from initial telephone screening interviews of women and men responding to cocaine research recruitment in a midwest urban environment over a two-year period. Female respondents (n = 88) were age- and race-matched with men interviewed over the same time period, for a total sample size of 176. Mean age of the female sample was 33 years and the majority were African-American. Basic demographics were similar for both genders. Respondents had first used cocaine at 24 years of age and currently smoked 2 g cocaine/day for 5 days/week, a rate higher than that found in many treatment samples. Women were found to have significantly higher rates of cigarette smoking, headaches and history of suicidal ideation, and significantly more women reported emergency room visits following crack use than did men. Equal numbers of men and women had been convicted of a crime (56%), with significantly fewer women reporting having committed a crime involving violence. Nearly all respondents (94%) reported that crack use had negative effects on their value systems, and significant numbers of both genders reported involvement with bartering crack and sex. Two-thirds of women able to become pregnant used no method of birth control and the use of barrier methods was infrequent. Forty-two percent admitted to using cocaine during pregnancy. These data indicate that while patterns of crack use per se do not differ between women and men in this sample, community outreach programs may benefit from focusing on other associated behaviors that do show differences between genders.

Adult↗
PubMed1993

Contraception during lactation.

The probability of pregnancy is very small during the first 2 months after delivery if the mother breast-feeds. The risk remains small for 6 months if the mother is fully breast-feeding her infant, is still amenorrhoeic and the child does not receive additional food. Under these conditions there is only about a 2% chance of pregnancy. Even full breast-feeding does not inhibit ovarian function after 6 months. Breast-feeding is a very important and efficient contraceptive method in the developing countries, but it is also a useful method in developed countries during the early puerperium. Barrier methods and progestogen-only hormonal methods (pills, implants and injectables) are the primary contraceptive alternatives during breast-feeding. They have no adverse effects on lactation, the condition of the infant or on maternal ovarian function. Sterilization is only a good alternative if the family wants a permanent method of contraception. Careful insertion of an IUD is possible even before the first menstrual period. Puerperal insertion of an IUD needs expertise and training because of the vulnerability of the very soft puerperal uterine wall. Combined oral contraceptives diminish milk production and therefore combined oral contraceptives are not recommended during lactation.

Amenorrhea↗
PubMed1999

Breakage and slippage of condoms among users in north Gondar Province, Ethiopia.

OBJECTIVE: To determine the frequency of condom breakage and slippage among male condom users and to analyse some factors affecting condom breakage. DESIGN: Prospective study undertaken from March to June 1996. SETTING: Gondar, Teda and Aykel health centres in north Gondar province. PARTICIPANTS: One hundred and seventy literate male condom users who volunteered to participate in the study were enrolled, but data were collected and analysed for 143 persons. MAIN OUTCOME MEASURES: Condom breakage was measured as the number of condom broken while opening the package, putting on, during intercourse or withdrawal; and condom slippage was measured as the number of condoms slipped off the penis during intercourse or withdrawal. RESULTS: Of 143 participants, 26.6% broke condoms. Total condom breakage rate was 4.6% and slippage rate was 0.1%; half of the condom breakage occurred at the tip. Condom breakage was more observed in less educated (p < 0.05). Breakage rate and experience of condom use were negatively correlated (r = -0.214, P < 0.05). CONCLUSION: User's knowledge and experience reduce the breakage of condom.

Adolescent↗
PubMed2003

Dilational surface viscoelasticity of polymer solutions.

A review of recent results on the dilational surface viscoelastic properties of aqueous solutions of non-ionic polymers is given. In the frequency range from 0.001 up to 1000 Hz the methods of transverse and longitudinal surface waves and the oscillating barrier method were applied. Viscoelastic behavior of adsorbed polymer films significantly differs from the behavior of films formed by only conventional surfactants of low molecular weight. For example, the dynamic surface elasticity of the former systems is low and almost constant in a broad concentration range. One can observe the increase of the surface elasticity only at extremely low concentrations and/or in the range of semi-dilute solutions. If the surface stress relaxation in conventional surfactant solutions is usually determined by the diffusional exchange between the surface layer and the bulk phase, the relaxation processes in the polymer systems proceed mainly inside the surface layer. Possible mechanism of the latter relaxation is discussed.

Biophysical Phenomena↗
PubMed2002

Contraceptive needs of the perimenopausal woman.

Although there are many definitions of the perimenopause, all include the concept of transition from physiologic ovulatory menstrual cycles to hyperestrogenic anovulation and ultimately to hypoestrogenic ovarian shutdown. With this comes a transition from childbearing, and its requirement for contraception, to the infertility of menopause. There is no contraceptive method that is contraindicated merely by age. The contraceptive needs of the perimenopausal woman, however, may be better suited to some methods over others. This article explores various methods of contraception for the perimenopausal woman, including female sterilization, barrier methods, intrauterine devices, injectables, implants, and oral contraceptives.

Climacteric↗
PubMed2005

[Reasons why sterilized women refused reversive contraceptive methods].

OBJECTIVE: To identify the representations of contraceptive methods within a group of sterilized women, aiming at understanding the reasons why they refused those methods. METHODS: A descriptive qualitative study was carried out on 31 sterilized women, randomly selected from a list of patients attending the Family Planning Program of a university hospital. Data was collected through a semi-structured interview. Interview transcription was analyzed according to the Content Analysis method. RESULTS: Refusal to other contraceptive methods was based on representations formed from a mixture of technical information received at health service units, their previous experiences with contraceptive methods and information received in the social environment. Rejection of high efficacy methods (hormonal and IUD) was mostly based on their low innocuousness; refusal to fertility awareness methods (calendar calculation, Billings ovulation method) was due to their low efficacy; and rejection of barrier methods (condom, diaphragm) was due to a culturally patterned sexuality full of interdictions as well as to their low efficacy. CONCLUSIONS: The option for female sterilization may be indicative of the refusal to the contraceptive alternatives offered by health services. Reproductive health professionals should increase in their practice the knowledge about personal, socio-economic and cultural factors that affect women's choice of a contraceptive method that could guarantee a better control over their own reproductive life.

Adult↗
PubMed1999

Eight years of experience in the first Romanian center of family planning and contraception.

This study describes 8 years of experience (1990-97) in the first Romanian center for family planning and contraception, which started in Bucharest at the Clinic Hospital of Obstetrics and Gynecology 'Prof. Dr. P. Sirbu' on 27 February 1990. A total of 14,258 women had attended the clinic by 1 January 1998. Trends in the use of contraceptives and the number of births and abortions at the center are described. During the 8 years, the induced abortions decreased by 65% and the uncompleted abortions (illegal abortions) by 45%. Hormonal contraception was the most commonly used contraceptive method (61.5%), followed by intrauterine devices (28.8%) and local contraception (barrier methods: condoms, diaphragms, spermicides) (9%).

Abortion, Induced↗
PubMed1998

Contraceptive technology and family planning services.

A large variety of modern contraceptives is now available, including several means to administer hormonal contraception, highly effective long-term methods and simple sterilization techniques. Methods under research include immuno-contraceptives for women and men, hormonal methods for men, new approaches to female hormonal contraception and improved barrier methods. Modern contraceptives are effective and safe for most women, and some methods have beneficial health effects other than prevention of pregnancy. However, underlying health conditions may decrease the safety of a given method. The appropriate use of the technology available requires screening for biomedical conditions and counseling that enables the selection of methods according to the life style of women and couples. Contraceptive methods have had a considerable positive impact on maternal and infant health and on population growth, but unwanted pregnancies and unsafe abortion still occur in large numbers. This shows the need to improve access to and quality of family planning services including the availability of contraceptives, sensitive providers trained in technical matters and communication skills, and communication between the community, the providers and the managers.

Chile↗
PubMed1990

Predicting contraceptive method usage among women in west Scotland.

Users of the six major methods of contraception are compared across a broad range of variables using data from a community sample. Differences between the groups were apparent for a range of socioeconomic and reproductive variables, and current users of the various methods also differed in their past use of contraception. Users of barrier methods fared particularly well. Few differences were observed for current health status or for the sociocultural variables examined, although users of natural methods differed from all others in their religious affiliation and commitment. Discriminant analysis showed that the most predictive variables distinguishing women who had opted for permanent methods of contraception (female sterilization and vasectomy) were the woman's stated reason for using her current method and her past contraceptive patterns; the inclusion of social, health and reproductive indicators did little to improve the prediction. It is argued that heightened expectations for contraceptive efficacy in the face of increasing concerns about long-term health consequences have contributed to the increased use of permanent methods.

Adult↗