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PubMed1993

[The clinical and lipid metabolic effects of a gestoden- and ethynyl estradiol-based monophasic contraceptive].

This is a clinical study to evaluate the efficacy, clinical side effects and in lipid metabolism of a new hormonal contraceptive preparation containing 75 mcg. of ethinyloestradiol. Thirty Mexican health women in reproductive age were studied for 12 months, giving a total of 360 cycles. The medication was highly effective for contraception, because pregnancies did not occur in this period. The clinical side effects were mild and less frequent that the ones informed with the use of other available hormonal oral contraceptives. In lipid metabolism, we did not find the adverse effects most frequently observed with the use of previous progestagens. This study, like previous ones, concludes that the combination of gestodene and ethinylestradiol is highly effective as a contraceptive with a low incidence of collateral side effects and due to its lack of interference with the metabolism of lipids is particularly suited for cases of high risk to develop pathology associated with alterations in lipid metabolism.

Adolescent↗
PubMed2005

Primary care services for an emergency department population: a novel location for contraception.

OBJECTIVE: To assess contraceptive provision site preferences in female urban Baltimore emergency department patients. METHODS: This cross-sectional questionnaire study was completed by 790 women, a population sufficient to detect a 10% intersite difference. The results were analyzed with chi-square, univariate and multivariate logistic regression analyses. RESULTS: Obtaining contraception other than from a physician's office was acceptable to 57.2% of the subjects, particularly those uninsured (p=.006) and without primary care providers (p<.001). Contraceptive provision in the emergency department (ED) was acceptable to 44.0%, particularly those who are frequent ED users (p=.003) and those at risk for unintended pregnancy (p=.024; pooled, p<.001). Care in nontraditional settings may preclude pelvic examination; 34.0% of the subjects felt safe obtaining contraception without this examination, significantly for those desiring contraceptive provision in the ED. CONCLUSION: Contraceptive services are acceptable in nontraditional settings, including the ED, particularly to women of limited resources. This service is acceptable without pelvic examination for a sizable proportion of the women using the ED.

Adolescent↗
PubMed2001

Support for school-based reproductive health services among South Carolina voters.

In 1997 a statewide random digit-dialed telephone survey of 534 South Carolina registered voters was conducted to determine level of support for school-based reproductive health services. Results indicated most voters supported services in secondary schools that would provide students with information and counseling about contraceptive methods and refer students to community-based agencies for abstinence education and counseling. Voters were less supportive of reproductive health services that would diagnose or treat sexually transmitted diseases, test for pregnancy, refer students to community-based agencies for contraceptives, or make contraceptives available to students at school. Significant associations in support for school-based reproductive health services were reported based on income, personal beliefs, intentions, and outcome expectations regarding sexuality education and contraceptive availability. These data reinforce the need for school-aged youth in South Carolina to have access to reproductive health services within their communities, outside of the school setting.

Adolescent↗
PubMed1999

[Contraception: gypsy versus non-gypsy women].

OBJECTIVE: To find the contraceptive methods used or known by women of fertile age, and find differences between gypsy and non-gypsy women. DESIGN: Descriptive study. SETTING: Primary care centre in El Prat de Llobregat (Barcelona). PARTICIPANTS: Women of fertile age, who were sexually active and did not wish to become pregnant, and who attended the centre for any reason. MEASUREMENTS: From March to August 1997, a survey was conducted in which personal data, number of sexual contacts, parity, use and knowledge of contraceptive methods, if and where their method is monitored, and satisfaction with their method were asked. RESULTS: 186 non-gypsy and 126 gypsy women answered the survey. The gypsy women knew less about barrier contraception (diaphragm p < 0.0001); IUD p = 0.0003; spermicides p = 0.001), periodic abstention (p = 0.002) and definitive methods (vasectomy p < 0.0001; tubal occlusion p = 0.0004). The commonest method used by the gypsy women was coitus interruptus (p = 0.0002). Gypsy women asked for less contraceptive advice and had less monitoring of their method (p = 0.001). They had more pregnancies which led to a greater number of live children (p < 0.0001) and induced abortions (p = 0.01). They lived more often with their sexual partner (p = 0.0005). CONCLUSIONS: Gypsy women know about safe methods but do not use them. They ask less for contraceptive advice and have more induced abortions. There should be family planning programmes aimed at this group, whose cultural and family features are distinct.

Abortion, Induced↗
PubMed1996

[Contraceptive use in women with heart disease].

PURPOSE: To analyse efficacy, tolerance and adverse events of reversible contraceptives in women with cardiac disease. METHODS: We studied prospectively during 24-39 (mean = 29) months, 89 women with heart disease with a mean age of 25.6 (16-42) years. Rheumatic heart disease was present in 73 (82%) cases, congenital heart disease in 11 (11%), coronary artery disease in 2 (2%) and cardiomyopathy in 3 (3%) case. The patients were divided in three groups: GCO--35 patients taking combined oral contraceptives (30 micrograms ethinyl estradiol and 75 micrograms gestodene--COs); GIT--27 using injectable progestagens (depot medroxyprogesterone acetate-DMPA) and GUID--27 with intrauterine device (IUD). RESULTS: In GCO occurred 4 (11.4%) cases of arterial hypertension, 1 (2.8%) of a transient cerebral isquemic attack, 3 (8.5%) of spotting, 1 (2.8%) of amnorrhea e 1 (2.8%) pregnancy. Interruption of this method occurred in 4 (11.4%) cases due to hypertension (2), pregnancy (1) and amenorrhea (1). In group GIT there were 2 (7.4%) cases of arterial hypertension, 18 (66.6%) of amenorrhea, and 3 (11.1%) of spotting. Interruption of use occurred in 5 (18.5%) due to amnorrhea (2), weight gain (2) and headache (1). In GUID there was 1 (3.7%) case of infeccion, 1 (3.7%) pregnancy and 1 (3.7%) spontaneous expulsion of IUD. Interruption of use took place in 3 (11.1%) cases due to infeccion, pregnancy and expulsion. The comparation between the groups demonstrated a difference in the incidence of amenorrhea (p < 0.005) and descontinuation of use of the method (p < 0.025). CONCLUSION: Use of reversible contraceptives in heart disease women was associated with an acceptable cardiovascular risk. Efficacy and side effects of the methods were comparable in the groups, however intolerance was more observed in GIT.

Adolescent↗
PubMedDate not supplied

How relationships of U.S. men affect contraceptive use and efforts to prevent sexually transmitted diseases.

CONTEXT: Comparatively little is known about how U.S. adult men's attitudes and characteristics influence their decision to use contraceptives to prevent pregnancy and to take actions to protect themselves from infection with sexually transmitted diseases (STDs). METHODS: Attitudinal and background data on 1,595 men from the 1991 and 1993 waves of the National Survey of Men (NSM) were used, through logistic regression techniques, to predict the likelihood of current contraceptive use to prevent pregnancy and recent efforts to avoid STD infection among men in three types of sexual relationship--marriage, cohabitation and dating. RESULTS: At the 1993 interview, 58% of men were using contraceptives to prevent pregnancy and 22% had recently taken actions to protect themselves from STDs. Men's concern about how easy a method was to use reduced the likelihood of STD protection, but had no influence on contraceptive use to prevent pregnancy; however, concerns about a method's risks to the female partner increased the likelihood of both outcomes. Couples in which the man expected his partner to take primary responsibility for contraception were 40% as likely to be protecting themselves against STDs as were couples in which the man believed he shared or had greater responsibility. Married men were the least likely to be protecting themselves against STDs, whereas men who were dating were the most likely to do so. CONCLUSIONS: Men's attitudes and characteristics were important predictors of contraceptive use to prevent pregnancy and of efforts to protect against STDs, even after controls for the female partner's characteristics were entered in the analysis. The findings emphasize the need to include men in interventions aimed at reducing unintended pregnancy and STD transmission.

Adult↗
PubMed1998

Uptake of family planning services among an ethnically mixed population in a general practice setting.

A descriptive study of the uptake of family planning services within an urban general practice which has a mixed ethnic population, was undertaken with the aim of identifying areas where uptake could be improved. The target population was 572 female patients aged between 16 and 45 years during the period August 1995 to July 1996. Of this target population, about 20 per cent had consulted the practice about contraception and four per cent were pregnant. These were excluded. The remaining majority had not consulted the practice about their contraceptive needs. The study looked in more detail at 194 patients who were available for interview, who had not attended the practice for family planning advice during three months from August 1, 1996 to October 31, 1996. Of these, a group could be identified who would have gained benefit from GP involvement. There were 22 'at risk' women who were not using contraception and 11 who had not returned for IUD checks. There was a definite preference for condom use among Asian patients. There was poor uptake of family planning services among 16 to 25 year old Asian patients. Some personal observations and suggestions, for improving uptake and compliance are given.

Adolescent↗
PubMed2006

The use of oral contraceptives among Finnish teenagers from 1981 to 2003.

PURPOSE: The teenage abortion rate has increased in Finland since 1995, after a long-term decrease. We studied changes in the use of oral contraceptives (OC) among 14-18-year-old Finnish girls from 1981 to 2003. METHODS: A self-administered questionnaire (the Adolescent Health and Lifestyle Survey) was sent biennially to a representative sample of 14-18-year-olds from 1981-2003. Numbers of respondents varied between 1200 and 4100 and response rates between 77% and 90%. Altogether, 35,939 girls participated. OC use, and individual, family, and place of residence factors were examined. Logistic regression models were run separately for 1981-1991 and 1993-2003. RESULTS: The proportion of OC users doubled from 1981 to 1991, from 9.5% to 19.3%. The rising trend leveled off after 1991 and settled down at around 19% to 20%. During both periods, OC use was higher among girls with early age at menarche, still in school at age 16-18 years, poor school achievement, living in one-parent families or with a stepparent, and girls whose parents had a low level of education. OC use decreased in the capital area in the early 1990s, unlike in other areas. CONCLUSIONS: Adolescent OC use increased in the 1980s. A decade later, despite known increase in sexual activity, OC use remained unchanged. This was probably a result of deteriorated access to contraceptive counseling after changes in health service, and may have contributed to the increased abortion rate. Except for a decrease in OC use in the capital area, the association of individual, family, and regional factors with OC use remained mostly stable during 1981-2003.

Abortion, Induced↗
PubMed2005

Advance supply of emergency contraception: a randomized trial in adolescent mothers.

OBJECTIVE: To examine whether the advanced provision of emergency contraception (AEC) to parenting youth would increase emergency contraception (EC) utilization, and whether AEC would impact the rates of unprotected sex and contraception use. DESIGN: Subjects were randomized to receive either information about EC or information and an actual supply of AEC. Subjects were interviewed at baseline, 6 and 12-month follow-up. SETTING: Urban non-medical case management office. PARTICIPANTS: 160 adolescent mothers (ages 13 to 20) who were receiving case management services. INTERVENTION: Advance supply of emergency contraception. MAIN OUTCOME MEASURES: Emergency contraception use, sexual activity, unprotected intercourse, contraceptive methods and use. RESULTS: Parenting teens who received AEC were much more likely to have used it than the control group at the 6-month interview (83% vs. 11%) and the 12-month interview (64% vs. 17%). Teens in the AEC treatment group were more likely to have unprotected sex at the 12-month follow-up interview (69% vs. 45%). There was no difference in condom use between the groups at either the 6-month, or the 12-month follow-up interviews. CONCLUSION: Advance provision of emergency contraception in parenting teens increases the likelihood of its use, and does not affect the use of condoms, or hormonal methods of birth control. Parenting teens who receive AEC may be more likely to have unprotected sex.

Adolescent↗
PubMed2001

[Men's acceptance of continuous hormone therapy].

The aim of the study was the assessment of males' willingness to long-term administration of hormonal drugs in substitutive and contraceptive means. Eighty males in their third and fifth decade were inquired a questionnaire. The patients were divided according to age into two groups: A (20-30 yrs of age) 55 males, and B (41-50 yrs of age) 25 males. University education was a condition required to be enrolled into the study. The results was statistically analyzed with Chi 2 test. 65.5% of males in their third decade would not accept hormonal contraception. 40% of males declared their acceptance for hormonal substitutive therapy and they were also aware of the necessity of prophylactic examinations, 7.3% accepted the therapy but without regular follow-ups, 16.3% did not accept the therapy and 36.4% did not consider it as necessary. 56% of the respondents from group B would accept an administration of contraceptive pill. 44% would not accept hormonal substitutive therapy, 24% did not see the necessity of the therapy, 16% would accept the therapy and the necessity of regular prophylaxis, and the last 16% would accept the therapy, however without control examining.

Adult↗
PubMed1995

The use of hormone replacement therapy; results of a community survey.

Hormone replacement therapy is used for both menopausal symptoms and in prevention, but for the latter to be effective there may be a need to promote its use. Suitable strategies need to be informed by current practice. A postal questionnaire was therefore sent to 1649 women aged 20-69 years in Stockton-on-Tees to assess which women consider and take hormone replacement therapy. The response rate was 74%. Therapy had been considered by 346 (28%) women of whom 164 (47%) were premenopausal. It was taken by 20% of women aged 45-65 years. Users were more likely to have taken the contraceptive pill. Use of therapy by women with osteoporosis or cardiovascular disease, or with a family history of these, was low. As women used to the idea of taking hormone replacement therapy and accustomed to taking the contraceptive pill reach menopausal age there is likely to be an increase in uptake of therapy. By targeting the 'at risk' groups of women, the primary care team may be able to make most effective use of the therapy and their own resources for the prevention of osteoporosis and cardiovascular disease.

Adult↗
PubMed1998

Sex education and contraceptive methods: knowledge and sources of information among the Estonian population.

A survey on sex education and contraceptive methods was carried out within a monthly EMOR Omnibus Survey. By using a questionnaire, knowledge and attitudes, as well as the main sources of information on contraceptive methods and sex education, among the Estonian adult population (n = 618) was investigated. Of the respondents, 68% were female and 32% were males: the mean age was 34 years. Almost all respondents expressed the opinion that sex education should start at school and that education on contraceptive methods would reduce the number of abortions. The majority of the respondents believed that it would be more convenient to visit a family doctor than a gynecologist for family planning. Main sources of information on contraception were: literature, doctors and journals, as rated by females; and literature, partners and television, as rated by males. The roles of the school nurse, father and siblings were rated as comparatively small. The level of respondents' knowledge of contraceptive methods was not too high. It is concluded that the prerequisites for changing sexual behavior and knowledge over a short time are wider use of mass media and better sex education at schools. Also, it is necessary to prepare family doctors to offer family planning services to their patients.

Adult↗
PubMed2001

Coping with changing conditions: alternative strategies for the delivery of maternal and child health and family planning services in Dhaka, Bangladesh.

The door-to-door distribution of contraceptives and information on maternal and child health and family planning (MCH-FP) services, through bimonthly visits to eligible couples by trained fieldworkers, has been instrumental in increasing the contraceptive prevalence rate and immunization coverage in Bangladesh. The doorstep delivery strategy, however, is labour-intensive and costly. More cost-effective service delivery strategies are needed, not only for family planning services but also for a broader package of reproductive and other essential health services. Against this backdrop, operations research was conducted by the Centre for Health and Population Research at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) from January 1996 to May 1997, in collaboration with government agencies and a leading national nongovernmental organization, with a view to developing and field-testing alternative approaches to the delivery of MCH-FP services in urban areas. Two alternative strategies featuring the withdrawal of home-based distribution and the delivery of basic health care from fixed-site facilities were tested in two areas of Dhaka. The clinic-based service delivery strategy was found to be a feasible alternative to the resource-intensive doorstep system in urban Dhaka. It did not adversely affect programme performance and it allowed the needs of clients to be addressed holistically through a package of essential health and family planning services.

Adult↗
PubMedDate not supplied

[Reproductive performance of female wistar rat, descendent of mothers treated with levonorgestrel during the lactation].

UNLABELLED: Levonorgestrel is one of the contraceptives used by women during lactation. Previous studies have shown that the administration of levonorgestrel to lactating female rats has affected the offspring, causing puberty delay in males and alterations on uterus and oviduct weight. PURPOSE: To study the reproductive capacity of F1 females from rats treated with levonorgestrel. METHODS: Female Wistar rats were treated with levonorgestrel (0.030 mg/1 ml of distilled water) from day 7 to day 13 after birth (day 1 = birth). On day 90 F1 females were mated with fertile males and insemination was confirmed by the presence of spermatozoa in the vaginal smear (first day of pregnancy). Inseminated females were distributed in three groups of 20 animals each (10 F1 control and 10 F1 treated). The animals were killed on days 2, 4 and 5 after insemination by ether overdose inhalation and the ovaries, oviducts and uterine cornua were removed. The ovaries were weighed and the corpora lutea counted. Oviducts and corpora lutea were washed with saline solution and the pre-embryos were counted and examined in all segments. RESULTS: The ovaries weight, the number of corpora lutea, the number and development phase of the pre-embryos were similar in both groups. CONCLUSION: In the experimental model used, F1 females whose mothers were treated with levonorgestrel during lactation, did not show any alteration in their reproductive capacity.

Animals↗
PubMed2000

Listening to youth: teen perspectives on pregnancy prevention.

PURPOSE: To ascertain views of public high school students on preventing teen pregnancy. The authors hypothesized that students at varying risk for pregnancy (e.g., abstinent, consistent contraceptors, inconsistent contraceptors) would have differing views which would have implications for future pregnancy prevention programming. METHODS: A 75-question anonymous survey designed for this study was administered in six Boston high schools. The sample consisted of 49% females and 51% males in 10th and 11th grades from diverse racial and ethnic backgrounds. One thousand surveys were received and analyzed using Chi-square tests to assess statistically significant differences in student responses. RESULTS: Sixty-three percent of the students had had sexual intercourse: 72% of males and 54% of females. Of these, 35% were consistent contraceptors and 65% were inconsistent. Students believed that having more information on pregnancy and birth control (52%), education about relationships (33%), parental communication (32%), improved contraceptive access (31%), and education about parenting realities (30%) would prevent teen pregnancy. Abstinent teens were more likely (58%) to say that information on pregnancy and birth control was important (p<.05), whereas consistently contracepting teens were more likely (40%) to identify greater access to birth control (p <.01). Males were more likely than females to prefer their information on contraception from parents (23% vs. 18%) and health education classes (16% vs. 7.5%), whereas females were more likely than males to prefer the health arena (51% vs. 27%) (p<.001). Teens using contraception were also more likely to be having frequent conversations with parents (49%) (p<.001). When asked why they had not used contraception, inconsistent contraceptors were more likely than others to say that they never thought of it (15%) (p<.001). CONCLUSIONS: Teens report that having more information from parents, school, and health arenas can prevent pregnancy. Abstinent, consistent contraceptors, and inconsistent contraceptors have different preferences regarding strategies. This information has important implications for educational content and policy discussions.

Adolescent↗
PubMed2001

Contraception and men attending a genitourinary medicine clinic.

AIMS: To identify men's knowledge and attitude to contraception and to determine whether there are differences in those men who have previous experience of termination of pregnancy (TOP) compared to those without experience. METHOD: Cross-sectional survey by written questionnaire of male attenders at a genitourinary medicine (GUM) clinic. RESULTS: In total 999 men, aged 15 to 70 years, completed questionnaires, 97.2% of those eligible. Over 96% of men wishing to avoid pregnancy with regular sexual partners were using contraception. However, with casual sexual partners 36% of men would not ensure that they were covered for contraception. The majority, 68.8%, of men did not have enough knowledge to access appropriate emergency contraception. Experience of a TOP was reported by 16.5% of men. Compared to men who did not have termination experience there were no differences in contraceptive use or their knowledge of emergency contraception. CONCLUSION: Use of contraception with regular sexual partners was good, but this was not the case with casual sexual partners or with respect to knowledge of emergency contraception. No significant differences were found in contraceptive use or attitudes between men with or without experience of TOP, but this may be influenced by several factors including the cross-sectional nature of the study. Improved targeting of men at the time of their partner's termination and the development of a National Sexual Health Strategy which takes into account men's needs may address this.

Abortion, Induced↗
PubMed1993

Family planning in Russia: experience and attitudes of gynecologists.

A survey was made of 375 Russian gynecologists. The questionnaire on family planning and contraceptives was distributed at the beginning of three local educational symposia. Almost all participants filled in the questionnaire on attitudes, knowledge and experience with family planning. The sample consisted of departmental specialists and heads of departments/clinics, working mainly at in- or out-patient women's health clinics. The mean age was 37 years; 83% were women, living in medium-sized or large cities (80%). Half of them had been working as a gynecologist for more than 10 years. Only 55% had been trained in family planning. The main reasons mentioned for the high abortion rate in Russia were the lack of education, non-involvement of male partner, and lack of modern contraceptives. Most of the gynecologists were in favor of special family planning clinics with special attention to services for the users. About half of the physicians knew how the pill works and estimated that 41% of women know that the pill contains estrogens. Sixty-two percent found that patients are badly informed about available contraception. Main sources of information on contraception were journals/books, colleagues and mass media. The majority reported having a directive style of patient counseling, and stated that parents should be informed of their teenagers' sexual experiences. The more experienced physicians with a training in family planning were better informed on contraception and showed a more patient-concerned attitude. It is concluded that health care providers should be the main target group of training and education in family planning, and need the support of Western European family planning organizations.

Abortion, Induced↗