Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CONTRACEPTIVES”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources

Phase II--clinical trial with biodegradable subdermal contraceptive implant Capronor (4.0-cm single implant). Indian Council of Medical Research Task Force on Hormonal Contraception.

The subdermal biodegradable contraceptive implant Capronor (4.0 cm) was implanted in 41 women to observe the efficacy and side effects. Only one pregnancy was reported at 10 months of use, and the life table continuation rate at 12 months was 82.2 per 100 users. No serious clinical side effects were reported during the study period. The menstrual pattern was disrupted during the first 3 months of implant use in two-thirds of the women which improved by the end of 12 months of use. The results of this Phase II study suggest that Capronor is a safe and effective long-acting contraceptive. These findings need to be confirmed in a Phase III clinical trial on a larger sample size.

Adolescent↗

A multicentre study of coagulation and haemostatic variables during oral contraception: variations with four formulations. Task Force on Oral Contraceptives--WHO Special Programme of Research, Development and Research Training in Human Reproduction, World Health Organization, Geneva, Switzerland.

OBJECTIVE: To explore the extent to which progestogen type and oestrogen and progestogen dose may modify the effects of combined oral contraceptives (OC) on coagulation and haemostasis. DESIGN: Randomized double-blind clinical trial. SETTING: Gynaecological clinics in Salvador (Brazil), Santiago (Chile), Singapore, and Dublin (Ireland). SUBJECTS: 622 women aged 18-35 years who had opted for oral contraception. A contrast group of 155 women who were not to receive OC was also studied. Both groups included approximately equal numbers from each of the four centres. INTERVENTIONS: Treatment of approximately equal numbers of women at each centre with one of the following OC preparations for at least 12 months: Norethisterone acetate (NEA) 1 mg + ethinyl oestradiol (EE) 50 micrograms; levonorgestrel (LNG) 250 micrograms + EE 50 micrograms; LNG 250 micrograms + EE 30 micrograms; LNG 150 micrograms + EE 30 micrograms. MAIN OUTCOME MEASURES: Changes over 12 months in 12 coagulation and haemostatic variables. RESULTS: At 12-month follow-up, the women on each OC preparation showed acceleration of prothrombin time and increase in factor X and fibrinogen. With the OC containing NEA there was also a persistent rise in factor VIIC, and reduction of antithrombin III and alpha 2-antiplasmin. The formulation which contained low doses of both LNG and EE showed the least adverse coagulation changes. Large increases in fibrinolysis were found in all OC groups. CONCLUSIONS: The adverse effects of combined OC on clotting are affected by the type and dose of progestogen as well as the dose of oestrogen.

Adolescent↗

[Problems of male contraception. 2. Male hormonal contraception, post-testicular points of attack, immunization and enzyme inhibition].

In principle control of male fertility is possible by mechanical, surgical and pharmacological methods. However, up to now only the following mechanical and surgical procedures are practicable: coitus interruptus, coitus condomatus and vasectomy. Since the safety of the latter is comparable to the pill, vasectomy is a major alternative to the contraceptive methods used by the female partner. Practical aspects of vasectomy and possible complications are reviewed. Finally, pharmacological approaches and problems involved in the control of male fertility are discussed with special reference to antispermatogenic substances, steroid hormones, immunization and enzyme inhibitors. The concept of antienzymatic contraception is based on the inhibition of penetration of enzymes (acrosin) localized within the acrosomal cap. Unfortunately, penetration of most of the acrosin inhibitors into the acrosome to inactivate acrosin is prevented by the high selectivity of the acrosomal membranes. Thus, pharmacological control of male fertility is still far from being practicable.

Acrosin↗

Oral contraception in diabetic women. A cross-over study on serum and high density lipoprotein (HDL) lipids and diabetes control during progestogen and combined estrogen/progestogen contraception.

Twenty-three young women with insulin-dependent diabetes were randomly allocated to contraceptive treatment with either a progestogen only (Lynestrenol 0.5 mg) (LYN) or a combined oral contraceptive (OC) (ethinyl estradiol 50 micrograms + lynestrenol 2.5 micrograms) (EE + LYN). After six months treatment the medication was withdrawn for at least two months, after which the patients were placed on the other preparation. Diabetes control and serum and high density lipoprotein (HDL) lipids were assessed before and after 1, 3 and 6 months of treatment. Low-dose LYN administration did not alter the insulin requirement, blood glucose or body weight while the combined EE + LYN treatment increased the insulin requirement (p less than 0.01) without altering blood glucose or body weight. Low-dose LYN reduced serum triglycerides (p less than 0.001), serum cholesterol (p less than 0.001) and serum phospholipids (p less than 0.01) without affecting HDL lipids, while EE + LYN gave an inconsistent increase in serum triglycerides (p less than 0.01) but no change in HDL lipids. These findings confirm our earlier results and we conclude that EE + LYN influences diabetes control slightly more (although still not seriously) than the low-dose LYN. It is suggested that insulin-dependent diabetics (in contrast to non-diabetics) are more sensitive to the influence of 19-norprogestogens than to alkylated estrogens, with respect to lipid metabolism.

Adolescent↗

Clinical comparison of monophasic oral contraceptive preparations of gestodene/ethinyl estradiol and desogestrel/ethinyl estradiol. Latin American Oral Contraceptive Study Group.

The efficacy, cycle control, subjective complaints, and safety of monophasic preparations of the oral contraceptives containing gestodene 75 mcg plus ethinyl estradiol 30 mcg versus desogestrel 150 mcg plus ethinyl estradiol 30 mcg were compared in a 6-cycle, open-label, parallel, randomized, multicenter phase IV clinical study in Latin America. Of a total of 176 women in each group, 163 in the gestodene group and 160 in the desogestrel group completed 6 cycles, providing data for 1,015 and 1,006 cycles, respectively. Subject compliance was excellent; pills were missed during only 6.9% of the cycles in each group. No woman became pregnant during the study. Gestodene group exhibited significantly better cycle control as evidenced by the lower incidence of breakthrough bleeding and spotting. Spotting in some cycles was reported by 11.9% of women taking the gestodene-combination compared with 21% of women taking the desogestrel-combination. Based on number of women, 86.4% of the gestodene group reported all cycles were normal (no BTB) compared with 76.7% of the desogestrel group. Also, the women in the gestodene group reported a significantly lower incidence of nuisance side effects during treatment cycles. No amenorrhea was observed for either group. There were no clinically significant differences between groups with respect to body weight, blood pressure, or laboratory evaluations. Seven women withdrew from the gestodene group and 8 women withdrew from the desogestrel group because of adverse reactions. The results of this study indicate that, although both OCs provided effective contraception, in comparison to the desogestrel-combination, the gestodene-containing OC is associated with better cycle control, less bleeding, and fewer subjective complaints.

Adolescent↗

Improved utilization of spacing methods--intrauterine devices (IUDs) and low-dose combined oral contraceptives (OCs)--through re-orientation training for improving quality of services. Indian Council of Medical Research Task Force on IUD and Hormonal Contraceptives.

A multicentre study was conducted by the Indian Council of Medical Research (ICMR) for improving the utilization of intrauterine devices (IUDs) and oral contraceptives (OCs) at the Post Partum Centres (PPCs) run by District/State Health Authorities. The ICMR's network of Human Reproduction Research Centres (HRRCs) had the technical responsibility for providing re-orientation training to health functionaries (medical and paramedical) of the PPCs for better quality of services and follow-up care for IUD and OC users. The uniform training module was utilized by all HRRCs which specifically assured for improving the counselling/motivational skills as well as screening procedures and management of side-effects and follow-up care by the health functionaries. A total of 4,808 IUD acceptors (2,446 of CuT 200 and 2,362 of CuT 380A) were observed for 84,070 women-months of use (42,433 and 41,637 months for CuT 200 and CuT 380A, respectively). The cumulative method failure rate at the end of two years was 0.7 per 100 users with CuT 200 and 0.3 per 100 users with CuT 380A. No perforations were reported with either types of the CuT devices. The reasons for discontinuations, like pain/bleeding and pelvic infections, were similar with both types of devices. The continuation rates with either CuT 200 or CuT 380A were around 89 and 76 per 100 users at the end of first year and second year of use, respectively, and were comparable. These observations at the post partum centres were similar to those observed earlier by the ICMR in phase III controlled clinical study. A total of 1,961 women were enrolled in the low-dose combined oral contraceptive (OC) group and were followed for 26,462 women-months of use. Two subjects reported pregnancy during regular use of pill, giving the method failure rate of 0.2 per 100 users at 2 years. The continuation rates of OC users were 58 and 37 per 100 users at the end of first year and second year, respectively. The major reasons for discontinuations were lost to follow-up, desire for pregnancy and other personal reasons. In spite of all efforts made by PPC staff as well as HRRCs to do follow-up, the lost to follow-up at two years was around 20 percent for IUD and 31 percent for oral pill users. These data suggest that while the re-orientation training package improved the quality of care resulting in higher continuation rates of IUDs and OCs at PPCs, the issue of follow-up care still requires further improvement in the National Programme.

Adult↗

Ischaemic stroke and combined oral contraceptives: results of an international, multicentre, case-control study. WHO Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception.

BACKGROUND: The association between use of oral contraceptives (OCs) and cerebral infarction was established in studies from northern Europe and the USA during the 1960s and 1970s. Since then, the constituents of hormonal OCs have changed and now contain lower doses of oestrogen and progestagen. Current recommendations restrict OC use to younger women who do not have other risk factors for cardiovascular disease. In this international study we assessed the risk of OC-associated first stroke in women from Europe and other countries throughout the world. METHODS: In this hospital-based, case-control study, we assessed the risk of ischaemic stroke in association with current use of combined OCs in 697 cases, aged 20-44 years, and 1962 age-matched hospital controls in 21 centres in Africa, Asia, Europe, and Latin America. The diagnosis of ischaemic stroke was almost exclusively based on computed tomography (CT), magnetic resonance imaging (MRI), or cerebral angiography carried out within 3 weeks of the clinical event. All cases and controls were interviewed while in hospital with the same questionnaire, which included information on medical and personal history, details of lifetime contraceptive use, and blood-pressure measurements before the most recent episode of OC use. FINDINGS: The overall odds ratio of ischaemic stroke was 2.99 (95% CI 1.65-5.40) in Europe and 2.93 (2.15-4.00) in the non-European (developing) countries. Odds ratios were lower in younger women and those who did not smoke, and less than 2 in women who did not have hypertension and who reported that their blood pressure had been checked before the current episode of OC use. By contrast, among current OC users with a history of hypertension, the odds ratio was 10.7 (2.04-56.6) in Europe and 14.5 (5.36-39.0) in the developing countries. In Europe, the odds ratio associated with current use of low-dose OCs (< 50 micrograms oestrogen) was 1.53 (0.71-3.31), whereas for higher-dose preparations it was 5.30 (2.56-11.0). In the developing countries, there was no significant difference between overall estimates of risk associated with use of low-dose or higher-dose OCs (3.26 [2.19-4.86] vs 2.71 [1.75-4.19]). This differential effect of dose in Europe and the developing countries is likely to be due to different levels of other risk factors among users of low-dose and higher-dose OCs in the two groups of countries. There was no significant increase in odds ratios with increasing duration of OC use among current users; odds ratios were not significantly increased after cessation of OC use. INTERPRETATION: The incidence of ischaemic stroke is low in women of reproductive age and any risk attributable to OC use is small. The risk can be further reduced if users are younger than 35 years, do not smoke, do not have a history of hypertension, and have blood pressure measured before the start of OC use. In such women OC preparations with low oestrogen doses may be associated with even lower risk.

Adult↗

Haemorrhagic stroke, overall stroke risk, and combined oral contraceptives: results of an international, multicentre, case-control study. WHO Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception.

BACKGROUND: The risk of haemorrhagic stroke associated with use of oral contraceptives (OCs) is less well-established than that for ischaemic stroke. We assessed the risk of haemorrhagic stroke associated with current use of modern OCs as now used throughout the world. METHODS: In this WHO collaborative, case-control study, we assessed the association between risk of haemorrhagic stroke and use of combined OCs in 1068 cases, aged 20-44 years, and 2910 age-matched controls. We also assessed risks for all strokes combined (haemorrhagic, ischaemic, and unclassified) based on 2198 cases and 6086 controls. FINDINGS: Overall, current use of combined OCs was associated with slightly increased risk of haemorrhagic stroke; the increase was significant in the developing countries (odds ratio 1.76 [95% CI 1.34-2.30]) but not in Europe (1.38 [0.84-2.25]). Use of OCs in women younger than 35 years did not affect risk of haemorrhagic stroke in either group of countries, whereas in women aged older than 35 years, odds ratios were greater than 2. Women who were current users of OCs and had a history of hypertension (detected before current episode of OC use, but not during pregnancy) had a substantially increased risk (ten-fold to 15-fold) of haemorrhagic stroke compared with women who did not use OCs and had no history of hypertension. Odds ratios among current OC users who were also current cigarette smokers were greater than 3. In both groups of countries, past use of OCs, dose of oestrogen, and dose and type of progestagen had no effect on risk, and risks were similar for subarachnoid and intracerebral haemorrhage. The odds ratios for any type of stroke associated with current use of low-dose (< 50 micrograms oestrogen) and higher-dose OCs were 1.41 (0.90-2.20) and 2.71 (1.70-4.32), respectively, in Europe and 1.86 (1.49-2.33) and 1.92 (1.48-2.50) in the developing countries. From these data we estimated that about 13% and 8% of all strokes in women aged 20-44 in Europe and the developing countries, respectively, are attributable to the use of OCs. INTERPRETATION: The risk of haemorrhagic stroke attributable to OC use is not increased in younger women and is only slightly increased in older women. The estimated excess risk of all stroke types associated with use of low-oestrogen and higher-oestrogen dose OCs in Europe was about two and eight, respectively, per 100 000 woman-years of OC use. However, findings need to be considered in the context of other risks and benefits associated with OC use, as well as those associated with the use of other forms of contraception.

Adult↗

[Contraception with the Lippes Loop D with or without contraceptive foam (author's transl)].

Contraception with Lippes Loop D was compared in 1 group of women (N 172) who used a spermicidal preparation with intercourse and a second group (N 190) who used no spermicidal preparation. In the group with a Lippes Loop and a spermicidal preparation, there were 1.2% unplanned pregnancies compared to 6.4% unplanned pregnancies without spermicidal preparation. This combined method approaches the reliability of oral contraception. The third group of women who used a spermicidal preparation erratically is not comparable in the statistical sense to the other two groups. However in this third group there were less unwanted pregnancies than in the group without the use of spermicidal preparation.

Contraceptive Agents, Female↗

[Electrophoretic study on the changes of serum protein fractions in Korean women--the effects of age, oral contraceptive, and intrauterine contraceptive device (author's transl)].

The serum levels of total protein, albumin, and electrophoretic fractions from 610 Korean women, 21-50 years, were measured to determine their relation to age, and the effects of oral contraceptives (OCs) (Norinyl), and Lippes Loop IUD. In normal women, total protein and albumin concentrations significantly decreased with age. Alpha2 and gamma globulin concentrations were decreased after the age of 40, but the statistical significance was low. Significant decreases in total protein and albumin concentrations were observed in OC and IUD users, and rapid decrease in total protein was observed in OC users rather than in IUD users. Beta globulin was slightly increased in both groups, and gamma globulin was decreased in OC users. No significant changes in alpha1 and alpha2 globulin concentrations were noted in either group.

Age Factors↗

Contraception with subdermal levonorgestrel implants as an alternative to surgical contraception at Ilorin, Nigeria.

Acceptability and social characteristics of a cohort of Norplant, IUD, pill and depo-med-roxyprogesterone acetate (DMPA) acceptors who were seen at the University of Ilorin Family Planning Clinic over a 10-week period of the pre-introductory clinical trial of Norplant, are compared. Findings indicate that Norplant and DMPA are adopted as an alternative to sterilization by women advanced in reproductive age and of high parity. The pill and IUD are adopted mainly as birth-spacing methods. Women's education, but not previous use of a contraceptive method, influenced the adoption of Norplant. The continuation rate at 12 months, a measure of acceptability, was highest, 93.7 per 100 women, for Norplant and 77.9, 46.7 and 27.7 per 100 women for the IUD, DMPA and the pill, respectively. The need to address the high family size norms in the African subregion is discussed.

Adolescent↗

Efficacy, acceptability and tolerability of the combined contraceptive ring, NuvaRing, compared with an oral contraceptive containing 30 microg of ethinyl estradiol and 3 mg of drospirenone.

PURPOSE: This randomized multicenter, open-label, trial compared efficacy, acceptability, tolerability and compliance of NuvaRing with a combined oral contraceptive (COC), containing 30 microg of ethinyl estradiol (EE) and 3 mg of drospirenone. METHOD: In this 13-cycle study, 983 women were randomized and treated (intent-to-treat population) with NuvaRing or COC. RESULTS: One in-treatment pregnancy occurred with NuvaRing (Pearl Index=0.25) (95% confidence interval [CI]: 0.006, 1.363) and four with the COC (Pearl Index=0.99) (95% CI: 0.269, 2.530). For both groups, compliance (89.2% NuvaRing, 85.5% COC) and satisfaction (84% NuvaRing; 87% COC) were high; the vast majority of women found NuvaRing easy to insert (96%) and remove (97%). Tolerability was similar; the most frequent adverse events with NuvaRing were related to ring use, whereas estrogen-related events were more common with the COC. CONCLUSION: NuvaRing has comparable efficacy and tolerability to a COC containing 30 microg of EE and 3 mg drospirenone. User acceptability of both methods was high.

Adolescent↗

Contraception in diabetic women: comparative metabolic study of Norplant, depot medroxyprogesterone acetate, low dose oral contraceptive pill and CuT380A.

OBJECTIVE: To evaluate the long-term intake of Norplant, depot medroxyprogesterone acetate (DMPA) and low dose oral contraceptive pill (OCs) on glycemic control, lipoprotein metabolism and coagulation profile in diabetic women. METHODS: Prospective comparative study including 80 uncomplicated controlled diabetic women. Twenty women allocated to each group. Clinical, metabolic and coagulation status were followed up at 3, 6 and 9 months' visits. RESULTS: Fasting blood sugar increased in OCs and DMPA users. Total cholesterol (TC) and LDL-cholesterol (LDL-C) decreased in all groups except DMPA where it increased. Triglyceride (TG) only increased in OCs group. HDL-cholesterol (HDL-C) increased with OCs and decreased with Norplant and DMPA. Compared to IUD users, significantly higher percentage TG and HDL-C and lower LDL-C were observed in OCs users, while DMPA users had significantly higher TC and LDL-C and lower HDL-C. Partial thromboplastin time was prolonged in Norplant users. CONCLUSION: In diabetics, Norplant results in minimal metabolic alterations followed by OCs while DMPA has unfavorable outcome.

Adult↗

Biological and chemical quality control of spermicidal raw material nonoxynol-9 and nonoxynol-9 containing vaginal contraceptive (ABF contraceptive film): determination of spermicidal activity and assay of nonoxynol-9.

The paper presents a routine biological and chemical quality control of nonoxynol-9 raw material and pharmaceutical formulation containing nonoxynol-9 (ABF contraceptive film). The biological control performed based on the determination and comparison of the spermicidal activities different dilutions of the standard raw materials solution and assay raw material or nonoxynol-9 pharmaceutical formulation solution on the human or breeding bull sperm using a modified Sander-Cramer method. The test preparations of the nonoxynol-9 raw materials or pharmaceutical formulation should show equal or higher spermicidal activity than the standard. The spermicidal activity should not be lower than dilution 1:90. The chemical control is performed based on the determination and comparison of nonoxynol-9 content in the standard raw material solution and assay raw material or nonoxynol-9 pharmaceutical formulation solution using UV-spectrophotometric method determining and comparing the absorbances at the maximum absorbance wavelength (275 nm). The content of nonoxynol-9 in the raw material assay solution or pharmaceutical formulation (ABF contraceptive film) should be within 90-110% of the declared value.

Animals↗

A comparative study of users of long-term contraceptive subdermal implants and female surgical contraception in Kenya.

This was a comparative study of users of Norplant contraceptive, Subdermal implants and LA Minilap, in rural, urban and peri-urban sites in Kenya during 1991-1993. Both methods are very well accepted by well counselled women seeking long-term, continuous, convenient, highly effective contraception. Norplant users had a mean age of 27.3 years, an average of 2.6 living children and 25.3 per cent were unmarried, while 32.9 percent had completed their families. This compares with 31.3 years, 6.2 living children, 0.6 percent unmarried and 100 percent completed families respectively for LA Minilap. Norplant acceptance rates have continued to rise over the few years since programme inception, and now stand at 5.4 percent of all new acceptors. LA Minilap acceptance trends shows a plateau or moderate down-turn at 21.6 percent of new acceptors. The possible reasons and implications of these observations, along with user characteristics are discussed.

Adolescent↗

The contraceptive effects of a new low-dose combination type oral contraceptive.

A study was carried out in 9 women volunteers to investigate the centron of 0.75 mg lynestrenol plus 0.0375 mg ethinyl oestradiol given for 22 days per cycle over a period of 6 cycles. The results of assessments of a number of hormonal, vaginal and cervical parameters showed that this combination has a two-fold effect: a central effect on the pituitary and a peripheral effect on the ovaries and on endometrial development. The findings of an effect on cervical mucus, as with higher dose combinations, were not sufficiently consistent to warrant a claim for a cervical barrier. The preparation appeared to be well tolerated but there was a high incidence of irregular bleeding in the first treatment cycle. In most of the women, however, this had corrected itself by the second cycle.

Adult↗

Why do inadvertent pregnancies occur in oral contraceptive users? Effectiveness of oral contraceptive regimens and interfering factors.

Inadvertent pregnancies in combined pill users are not uncommon, and are usually due to errors of tablet taking. However, many factors may contribute to 'pill failure'. In this review the endocrine pharmacology of pill use and the changes reported with missed pills have been considered in detail. The influences of other factors including drug interactions have been reviewed and a series of recommendations made for reducing the risk of pregnancy in each of these circumstances.

Anti-Bacterial Agents↗