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PubMedDate not supplied

Pelvic actinomycosis and usage of intrauterine contraceptive devices.

Pelvic inflammatory disease (PID) is one of the most commonly encountered serious infectious disease entities in gynecology. The past decade has witnessed many advances in our understanding of the pathogenesis of PID. It is now evident that such pelvic infections are largely polymicrobial in origin, with major involvement by anaerobic organisms. Salpingo-oophoritis is a part of the spectrum of PID. Included among this group of infections are tubo-ovarian abscesses, traditionally referred to as either gonococcal or non-gonococcal in origin. Within the latter group of infections the importance of anaerobic organisms has also been elucidated. Of particular interest is the reported observation of an increased frequency of salpingo-oophoritis among users of intrauterine devices (IUDs). These reports have noted the specific occurrence of serious pelvic infections due to Actinomyces species, and this will be the topic of the infectious disease conference. Our patient presented with a chronic illness characterized by lethargy, back pain, fever, and anemia; subsequently evaluation disclosed the presence of a large pelvic mass which was confirmed as a tubo-ovarian abscess at surgery. Histological evaluation demonstrated involvement by Actinomyces species. This patient's illness is discussed as a complication of chronic IUD usage with reference to specific management for this emerging problem.

Abscess↗
PubMed2004

Passive cigarette smoking is a risk factor in cervical neoplasia.

OBJECTIVES: To determine the role of spouse's cigarette smoking in the detection of high-grade squamous intraepithelial lesions of the cervix. DESIGN: Prospective cohort study with multivariate analysis. SETTING: Colposcopy clinic in a tertiary hospital. PARTICIPANTS: Women referred to a colposcopy clinic for evaluation of abnormal Papanicolaou smears showing either repeated inflammatory changes, low-grade squamous intraepithelial lesion (LSIL), or high-grade squamous intraepithelial lesion (HSIL). Data collection. The women were interviewed with a structured questionnaire for sexual history, use of oral contraceptive pills, personal and spouse cigarette-smoking history, and obstetric history. RESULTS: There were 623 women in the cohort. They were grouped into normal, LSIL, and HSIL categories based on colposcopy and histologic assessment. There were very few women who had had more than one sexual partner or a history of sexually transmitted diseases (STDs). The prevalence of oral contraceptive pill usage was 2.9% among the women in the normal group, 4.3% in women with LSIL, and 5.1% in women with HSIL. The incidence of cigarette smoking by the women was 2.5%, 3.2%, and 6.8% for the three groups of women, respectively. The incidence of spouse cigarette smoking was 25%, 35%, and 43% respectively. Compared to women in the normal group, women with HSIL were younger at first sexual intercourse, more likely to smoke cigarettes, and have spouses who smoked cigarettes. After controlling for age, age at first sexual intercourse, usage of combined contraceptive pills, and the woman's own cigarette-smoking habit, the odds ratio for HSIL was 1.046 for every stick of cigarette smoked by the spouse. In other words, the risk of detection of HSIL increased by 4.6% for every stick of cigarette her spouse smoked. CONCLUSIONS: Among women attending a colposcopy clinic, the risk of detection of HSIL increases with the spouse's cigarette-smoking habit. Further studies are warranted in quantifying the risk in a general population.

Adult↗
PubMed1998

Breast cancer risk among women under 55 years of age by joint effects of usage of oral contraceptives and hormone replacement therapy.

OBJECTIVE: To assess effects on breast cancer risk of exposure to both oral contraceptives and menopausal hormones, an increasingly common exposure. DESIGN: A case-control study of breast cancer among women under the age of 55 years in Atlanta, GA involving 1,031 cases and 919 population controls was conducted. RESULTS: Ever use of oral contraceptives was associated with a relative risk of 1.1 (95% 0.9-1.4), whereas the relative risk for hormone replacement therapy was 0.9 (95% CI 0.7-1.2). Seventeen percent of the cases versus 19% of the population controls reported exposure to both agents, resulting in a relative risk of 1.0 (95% CI 0.7-1.4) relative to those unexposed to either preparation. Although there was little variation in risk associated with joint effects by either age or race, there were statistically nonsignificant elevations in risk for this exposure among women who had experienced a natural menopause (relative risk = 2.0, 95% CI 0.7-5.6), were relatively thin (relative risk = 1.5, 0.8-3.0), or who had a first degree relative with breast cancer (relative risk = 2.0, 0.6-7.0). When joint effects of longer term use of both agents were considered, subjects who reported use of oral contraceptives for 10 or more years and hormone replacement for 3 or more years had a relative risk of 3.2 (95% CI 1.4-7.4) compared with nonusers of either preparation. CONCLUSIONS: Although our results must be cautiously interpreted given small numbers within subgroups, they raise concern and emphasize the need for further evaluation on breast cancer risk of the increasingly common exposure to both oral contraceptives and hormone replacement therapy.

Adult↗
PubMed1995

[13C]Aminopyrine breath test detects altered liver metabolism caused by low-dose oral contraceptives.

The [13C]aminopyrine breath test measures hepatic mixed function oxidase activity. The cumulative percent dose recovered over 2 hr is a sensitive indicator of hepatic dysfunction; values < or = 7.0% have been shown to indicate severe liver disease. Previous studies have suggested that the test results may be influenced by the use of oral contraceptives steroids. We compared the results from five non-oral contraceptive-using women with those from 31 women whose duration of oral contraceptive steroid usage ranged from 4 to 204 months. The women were taking one of four oral contraceptive formulations that differed in the amounts of estrogen (20, 35, or 50 micrograms with 1 mg progesterone) and progesterone (35 micrograms estrogen with stepped levels of progesterone of 0.5, 0.75, and 1.0 mg). The [13C]aminopyrine breath test was performed on days 21 and 28 of the menstrual cycle. Cumulative percent dose recovery values among the normal menstrual cycle of non-oral contraceptive steroid-using women were 12.1 +/- 1.6 and 11.8 +/- 1.5% (mean +/- SD). In contrast, oral contraceptive steroid users showed a marked reduction in cumulative percent dose recovery at 21 days, averaging 6.1 +/- 2.3% (P < 0.001), and returned to normal values (10.2 +/- 3.5%) at 28 days in most women(seven days after oral contraceptive steroid usage was paused). The adverse impact on hepatic mixed function oxidase by oral contraceptive formulations did not differ on the basis of estrogen or progesterone content. The adverse impact of oral contraceptive usage on the mixed function oxidase activity measured by the [13C]aminopyrine breath test must be considered for women of childbearing potential.

Adult↗
PubMed1979

Factors associated with ex-nuptial birth.

The paper examines the background to 210 live exnuptial births studied in the first phase of the Christ-church Child Development Study. The results show: 1. That nearly half of the children had been conceived within cohabiting situations. 2. That nearly one in five ex-nuptial children was the result of a planned pregnancy. 3. Maternal reactions to the birth and pregnancy varied with the mother's situation: cohabiting mothers reported considerably less adverse reaction to the birth than did non-cohabiting mothers. 4. Overall, mothers of ex-nuptial children had a fairly sophisticated appreciation of contraceptive methods. 5. One quarter of unplanned ex-nuptial pregnancies were the result of contraceptive failure and three-quarters were the result of contraceptive non-usage. 6. In common with previous findings for nuptial pregnancies, about 35 percent of unplanned ex-nuptial pregnancies were ascribed to a breakdown in the mother's pattern of usage of the contraceptive pill.

Adolescent↗
PubMedDate not supplied

Do oral contraceptives inhibit Trichomonas vaginalis?

Usage of oral contraceptives was recorded for 114 women with trichomoniasis, 179 women with yeast infection, and 333 women with gonorrhea. Usage by each group was compared with that of 517 women with no genital infection. The proportion of oral contraceptive users was significantly smaller among those with trichomoniasis (P less than 0.002), significantly larger among those with yeast infection (P less than 0.001), but not significantly different among those with gonorrhea. Among 80 women with both trichomoniasis and gonorrhea, a significantly smaller proportion used oral contraceptives as compared with a group of 253 women who had gonorrhea alone (P less than 0.002). The results suggest that oral contraceptives may inhibit trichomoniasis and enhance infection of the vagina by yeasts.

Adolescent↗
PubMed1994

[The history of family planning among women who opt for surgical sterilization in the Social Security Fund of Panama].

In this study, the previous history of family planning and prior usage of contraceptive methods are analyzed, in a sample of 175 women who voluntarily opted for surgical sterilization as a permanent method of fertility regulation, in the Panamanian Social Security System. A questionnaire was applied during the second trimester of pregnancy, by which information would be gathered in regard to knowledge, usage and adverse effects of the contraceptive methods used prior to the intervention. Results showed that 99% of the sample had heard, on some occasion about oral contraceptives (OC) and, in lesser proportion to intrauterine devices (IUD), barrier methods and hormonal inyectables. The first contraceptive method used, and the one of longest usage, was the combined OC, of which 43% begun between 17 and 25 years of age. In contrast, 7.4% initiated contraception with IUD, from the age of 26 years. The health personnel constituted the major source of recommendation for contraceptive usage and, despite the fact that 37% of the sample did not use contraception prior to the last pregnancy, over half of the subjects responded that combined OC were considered as the most secure method.

Adult↗
PubMed2004

Frequency of risk factors for cervical cancer among women in fertile age.

Cervical and breast cancer are usually type of tumor that are found among women in fertile age in Bosnia and Herzegovina. Final goal was to establish frequency of risk factors that are responsible for development of those types of cancer as well as establish possibility of prevention, according to the existence of each risk factor. Research was conducted through out surveys among women which were selected by accident. The amount of questioned women is 200, and out of that number 70 (35%) were out of rural environment, 130 (65%) were from urban environment which led to statistic- processed information. Variables that were defining our interviews were: age, marital status, education level, stay during the war in B&H, number of given birth, consistency of gynecological examinations, changes that were found during the medical (gynecological) examination, number of sexual partners, usage of contraception, existence of sexual infections, usage of tobacco, existence of genetic factor. The most important fact is that over 50% of interviewees do not visit gynecologist, and that the gynecological infections are frequent. Usage of tobacco is in high percent founded among interviewees from urban environment (85%).

Adolescent↗
PubMed1993

Combined oral contraception with desogestrel/ethinyl estradiol: tolerability profile.

Since their introduction nearly 30 years ago, oral contraceptives have been widely researched regarding their contraceptive and noncontraceptive effects. With proper usage, oral contraceptives provide highly effective contraception. In addition, oral contraceptives confer significant noncontraceptive health benefits, including prevention of ovarian and endometrial cancer and reduction in the incidence of pelvic inflammatory disease, endometriosis, benign breast disease, and dysmenorrhea, among others. Today's low-dose oral contraceptives have an improved safety profile when contrasted with their early higher dose counterparts. Yet oral contraceptive use continues to be associated with a variety of minor side effects, which range from menstrual changes such as breakthrough bleeding, spotting, or amenorrhea, to androgenic effects, including weight gain and acne. These androgenic effects are important factors in patient discontinuation of oral contraceptives. Progestins with increased selectivity have the potential to cause fewer androgenic side effects while retaining appropriate progestin suppression of the endometrium and hypophyseal-pituitary-ovarian axis. A combination oral contraceptive (30 micrograms of ethinyl estradiol with 150 micrograms of desogestrel) has been evaluated extensively by European investigators. This literature suggests that a low-dose oral contraceptive formulated with the selective progestin desogestrel offers a favorable profile of reduced androgenic side effects while retaining the cycle control associated with low-dose oral contraceptives currently marketed in the United States.

Acne Vulgaris↗
PubMed1995

University students' subjective experiences of oral contraceptive use.

A substantial proportion of women who commence oral contraceptive discontinue usage due to unwanted side-effects. In investigations of side-effects in current users, such women are excluded, and hence such studies will tend to underestimate the prevalence of side-effects. One hundred and forty-five female university students (both former and current users) completed a questionnaire focusing on their experiences of the impact of oral contraceptives upon their psychological and physical well-being. Although, on average, over half the women reported no effect, the vast majority of those who did report a change in well-being deemed this to be negative. The only exception was pelvic pain which was reported to be improved by oral contraceptive use.

Adult↗
PubMed1990

[The ultrastructural changes occurring in the endometrium of women who use intrauterine pessaries].

The authors studied ultrastructural changes in the endometrium of 25 women, using intrauterine contraceptive devices, preventing conception, during various time limits. The material of the endometrial biopsy was fixed with glutar and osmium in a phosphate buffer and embedded in durcopan. Section were prepared by a microtome and observed under electron microscope of Hitachi type. Comparing the parameters duration of usage of loops and character of changes in the endometrium an impression was obtained that the usage of contraceptive intrauterine devices for one-year period did not induced changes of pathological character. Functional changes in the endometrium occurred after a two-year stay of the loop in the uterus as there were inflammatory changes of spot-like character in two of the sections. Local areas of inflammation of nonspecific character, manifested under the form of lymphocytes and leucocyte accumulation, were found in women with long usage of contraceptive intrauterine devices. The authors advise to remove the loop 2.5-3 years after its application and to wait for the complete regeneration of the endometrium.

Endometritis↗
PubMed2005

The unmet need for contraception among Nigerian women in the first year post-partum.

OBJECTIVE: To determine the level of Unmet need for Contraception among women in the first year post-delivery in Ile-Ife, Nigeria. METHODS: A prospective study of 256 women attending antenatal clinic of the OAUTHC, Ile-Ife, Nigeria was carried out 9-10 months post-delivery. Using a semi-structured questionnaire, the respondents were interviewed for socio-demographic characteristics; obstetric, sexual, and contraception history were also taken. The data were analyzed using descriptive and inferential statistical methods. RESULTS: There was a high level of unmet need (59.4%) in the sample of Nigerian women despite a high level of awareness of common methods of contraception. Education and parity had no significant effect on usage of contraception (p > 0.05). No reason was given for non-usage in the largest proportion (30.3%) of the non-users. Only one-third of the respondents could correctly report the 'at-risk' period for getting pregnant in the post-partum period. CONCLUSION: There is a need to study in more detail the social and cultural factors that determine contraceptive utilization before success can be achieved in closing the gap of unmet need, as it has become evident that increasing the awareness and knowledge of contraception is not enough to achieve the objectives of family-planning programs.

Adolescent↗
PubMed1979

A prospective, randomized study of oral contraceptives: the effect of study design on reported rates of symptoms.

A study was undertaken to assess the effects of the study design (frequency and method of inquiry about the side effects) on the reporting of oral contraceptive (OC)-associated side effects. The study found that the one-contact-per-cycle schedule yielded consistently lower rates of side effects than the two-contact-per-cycle schedule. Also, asking subjects about the occurrence of specific symptoms led to the reporting of higher rates of side effects than those obtained by general inquiry. The study suggests that differences in the reported rates of side effects may be due in part to the manner in which the data were collected.

Contraceptives, Oral↗
PubMed1980

Comparison of a paper pill with a conventional oral contraceptive tablet.

A multicentre clinical trial comparing a novel formulation (the Paper Pill) of a combined oral contraceptive containing 30 microgram ethinyloestradiol and 150 microgram levonorgestrel with a conventional tablet formulation (Microgynon 30) has been carried out in 336 women over 6 cycles. There were no pill failures in women taking either preparation with one exception in the Microgynon 30 group which was due to poor patient compliance. Cycle control judged by cycle length, duration and amount of withdrawal bleeding and the incidence of intermenstrual bleeding was good in both groups. The number of adverse effects was slightly less in the Paper Pill group and fewer withdrawals for questionnaire reasons were noted than in the Microgynon 30 group. A questionnaire showed that the Paper Pill was accepted well by the majority of women in the trial.

Administration, Oral↗