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PubMed1996

[How do self-observed cycle symptoms correlate with ovulation?].

The symptoms of self-observation of the menstrual cycle (basal body temperature, mucus symptom, autopalpation of the cervix) are often regarded as not reliable for ovulation detection. In a prospective study 87 NFP cycles are monitored additionally with ultrasound and LH tests to calculate the correlation of the ovulation-time with the symptoms of self-observation. Our results show that the symptoms of self-observation allow a reliable detection of the time of ovulation. Only a short introduction into the method of self-observation is a necessary precondition. The reliable detection of ovulation gives the opportunity of cycle analysis of large groups especially in long time investigations. In this way a large set of valuable and reliable data on normal and disturbed menstrual cycles will be available.

Adult↗
PubMed1998

Retrospective clinical trial of contraceptive effectiveness of the electronic fertility indicator Ladycomp/Babycomp.

The Babycomp/Ladycomp (Valley Electronics Ltd., Eschenlohe, Germany) is an electronic device that combines the temperature method and calendar method for planning and preventing pregnancy by identifying the fertile and infertile phases of the menstrual cycle. In a retrospective clinical trial, the system was tested as a contraceptive aid. A total of 648 women from Germany and Switzerland have participated: 597 women with 10,275 months of use used the device for contraception. Thirty-three unplanned pregnancies were identified, giving a total pregnancy rate of 3.8 use effectiveness according to the Pearl Index. Six method-related pregnancies occurred, producing a method Pearl Index of 0.7. Calculating the cumulative pregnancy rates by life-table analysis, it was found that, after about one year of exposure, the probability of an unintended pregnancy was 5.3% (0.053), after 2 years it was 6.8% (0.068) and after about 3 years of exposure it was 8.2% (0.082). The mean length of the identified fertile period was 14.3 days with a standard deviation of 4.6 days in all cycles reported. The acceptance of the device by the woman and her partner was good. In fact, 21 of the 33 women who became pregnant would still recommend the device for further use (63.6%).

Actuarial Analysis↗
PubMedDate not supplied

[Contraception before pregnancy. Evolution between 1972 and 1975 in the Rhone-Alpes region (author's transl)].

The studies was made from two enquiries carried out on women who delivered in June 1972 and 1975 in the Rhone-Alpes region. Contraception therefore dealt exclusively with birth control before a pregnancy. It is clear that contraception has developed significantly: it is practised by 48% of women who were questioned in 1975 as compared with 41% in 1972. There is also a change in the last method used between the two dates: the pill featured in only 17% of all the method used in 1972 and 45% in 1975: on the other hand coitus interruptus went down from 41% to 21%. The spread of the use of the pill is a generalised phenomenon whereas there are several categories of women who do not seem to have used, coitus interruptus less frequently. As far as the social classes are concerned, it is to be pointed out that only non-skilled working-class people have not changed their habits as far as these two methods are concerned. Contraception is practised with more and more success as a method of birth control: on the one hand the number of conceptions which occurred when the women was using a birth control method has gone down from 27% in 1972 to 15% in 1975: on the other hand 51% of those who used a birth control method stopped using it in order to have a baby, whereas in 1972 only 32% did so. Parallel with this evolution, one can point out that the number of women who have 2 or more children has gone down. On the other hand the number of conceptions before marriage and the rhythm of the way the families are constituted has not changed between the two dates.

Adolescent↗
PubMed2002

Timing intercourse to achieve pregnancy: current evidence.

Physicians who counsel women for preconception concerns are in an excellent position to give advice to couples regarding the optimal timing of intercourse to achieve pregnancy. The currently available evidence suggests that methods that prospectively identify the window of fertility are likely to be more effective for optimally timing intercourse than calendar calculations or basal body temperature. There are several promising methods with good scientific bases to identify the fertile window prospectively. These include fertility charting of vaginal discharge and a commercially available fertility monitor. These methods identify the occurrence of ovulation clinically and also identify a longer window of fertility than urinary luteinizing hormone kits. Prospectively identifying the full window of fertility may lead to higher rates of conception. Proper information given early in the course of trying to achieve pregnancy is likely to reduce time to conception for many couples, and also to reduce unnecessary intervention and cost.

Adult↗
PubMed2002

Natural contraception using the Billings ovulation method.

OBJECTIVE: The Billings ovulation method (BOM) is a medical model of a natural procreation education method based on scientific observation of the changes in the cervical mucus. In this study we examined Turkish women's interest in accurate usage of cervical mucus changes in determining the ovulation time. METHOD: Fifteen regularly cycling women monitored their fertility patterns in 30 cycles using the BOM and urine luteinizing hormone (LH) kits. At the end ofeach cycle, the cervical mucus monitoring chart and LH kits were collected from the subjects and analyzed. RESULTS: The cervical mucus symptoms defined a potential fertile period of 10 days' average length, with the 'peak' mucus characteristic occurring at a mean of day 13.65 +/- 2.62 of the cycle. The duration ofthe LH surge, as observed in early morning urine samples, averaged 5 days, with the peak occurring at a mean of day 13.40 +/- 2.58 of the cycle. Data indicated that there was a strong correlation between LH in the urine and the peak in self-observed, cervical-vaginal mucus (p = 0.001). CONCLUSION: This study proved that women can distinguish patterns of ovulation and anovulation by self-detection of variations in cervical mucus characteristics, and that urinary LH levels strongly correlate with ovulation.

Adult↗
PubMedDate not supplied

New low- and high-tech calendar methods of family planning.

Calendar-based methods are not usually considered effective or useful methods of family planning among health professionals. However, new "high-" and "low"-tech calendar methods have been developed, which are easy to teach, to use, and may be useful in helping couples avoid pregnancy. The low-tech models are based on a fixed-day calendar system. The high-tech models are based on monitoring urinary metabolites of female reproductive hormones. Both systems have high levels of satisfaction. This article describes these new models of family planning and the research on their effectiveness. The author proposes a new algorithm for determining the fertile phase of the menstrual cycle for either achieving or avoiding pregnancy.

Algorithms↗
PubMed2006

Ethnic Korean women's perceptions about birth control.

CONTEXT: We see many Korean women in our clinics and we have found them to have negative attitudes to hormonal contraception. We need to understand their perceptions and experiences with contraception in order to improve the effectiveness of our contraceptive counseling. METHODS: This was a qualitative descriptive study, conducted in an urban family practice office. The participants were a convenience sample of 40 ethnic Korean women. Data were collected in semistructured interviews by one interviewer who is fluent in English and Korean. Transcribed interviews were analyzed to identify salient themes. RESULTS: There was a deep distrust of hormonal methods of contraception and belief that hormones caused permanent harm. Unlike the findings in our other studies of Asian women, these women were satisfied with their usual methods of combining condoms, rhythm and withdrawal. They described good communication with their partners (which is necessary for the effective use of their chosen approaches). CONCLUSION: When counseling Korean women about contraception, it is important to discuss the cultural bias against hormonal contraception involving beliefs that hormones cause permanent harm. It is also important to recognize the very successful use of condoms, rhythm and withdrawal by these couples.

Adolescent↗
PubMed1989

Adolescent contraception: nonhormonal methods.

A comparison of the advantages, disadvantages, and costs of each method is presented in Table 1. Barrier methods of contraception offer adolescents protection against both pregnancy and STDs, but innovative approaches are needed to enhance availability and acceptability. Condom use in conjunction with a vaginal spermicide would provide optimal protection. The "female condom" may prove to be an effective alternative. Diaphragms and cervical caps can be prescribed for well-educated, highly motivated adolescents comfortable with insertion and removal. The vaginal contraceptive sponge provides many of the advantages of the diaphragm and cap without the need for an examination and fitting and also may be used as a backup method with the condom. Vaginal spermicides used alone are significantly less effective than in combination with a mechanical barrier. The IUD is not considered appropriate for most adolescents due to its association with an increased risk of pelvic infection. Periodic abstinence requires accurate identification of the fertile period, extensive education, and partner cooperation. Sterilization is rarely considered an option in adolescents. Alternate forms of sexual expression are available to adolescents who choose to abstain from intercourse.

Adolescent↗
PubMedDate not supplied

Contraceptive failure in the United States: an update.

This report provides an update of the authors' previous estimates of first-year probabilities of contraceptive failure for all methods of contraception. Estimates are provided of failure during typical use (which includes both incorrect and inconsistent use) and during perfect use (correct use at every act of intercourse). The difference between these two probabilities provides a measure of how forgiving of imperfect use each method is. These revisions are prompted by recent studies that provide the first estimates of failure during perfect use for periodic abstinence and the cervical cap, by more complete evaluations of implants, and by the appearance of the Copper T 380A and disappearance of other IUDs from the US market. Also provided is a more complete explanation of how the previous estimate of the probability of becoming pregnant while relying solely on chance should be interpreted, and this estimate is revised slightly downward.

Clinical Trials as Topic↗
PubMed2005

Transvaginal contraception--avoid the bladder.

We report two cases of female contraceptive methods, resulting in urological presentation, with bladder foreign bodies. History, mode of diagnosis and surgical extraction technique differed in both patients. The first, where a thermometer was lost intravesically whilst measuring an internal temperature, presented immediately. A plain abdominal X-ray confirmed the position of the foreign body. Extraction was performed cystoscopically with the thermometer intact. A second patient, with recurrent urinary tract infections, was found to have an intrauterine contraceptive device (IUCD) in her bladder on ultrasound. Attempts to remove it endoscopically failed, and an, open procedure was required to free the IUCD from the bladder sidewall.

Adult↗
PubMed1988

Natural methods for fertility control: a prospective study--First Part.

This study describes 4 years of verification of effectiveness and applicability of BBT and symptothermal methods. The couples chosen had to undergo a 6-month-long study phase, and be psychologically motivated and well trained in NFP. During this period, particular emphasis was given to the motivational factor, which was expanded in its anthropological, relational, pedagogical and, sometimes, moral contents. Four hundred and sixty couples entered the program, for a total of 8,140 cycles, in which BBT, cervical mucus, and intercourse were charted. The Pearl Index for unplanted pregnancies was 3.6. Twenty-five unplanned pregnancies occurred in couples using NFP for spacing, and no pregnancies were reported in limiters.

Adult↗
PubMed2006

Quality of delivery of the Standard Days Method as compared with contraceptive pills in Rwanda.

BACKGROUND AND METHODOLOGY: Replicating a Peruvian study, this research introduced the Standard Days Method (SDM) into Rwanda Ministry of Health clinics and evaluated client counselling on the new method against that given for contraceptive pills. Providers received technical reinforcement concerning established methods in addition to SDM training. To evaluate their quality of care, simulated clients implemented a service test in visits to 20 clinics. RESULTS: As in Peru, providers exchanged significantly more relevant information with clients who chose SDM than with those who chose pills. Also, a minority of providers posed barriers to SDM access by refusing to give SDM tools to the client until she brought her partner for consultation. CONCLUSIONS: The findings of this study confirm that SDM counselling is generally satisfactory, although SDM training needs adjustment, and that the rigour of providers' pill counselling remains below capacity.

Contraceptives, Oral↗
PubMed1984

A comparison of three social-psychological models of attitude and behavioral plan: prediction of contraceptive behavior.

We compared the predictive validities of three prominent models of attitudes and behavioral decisions: Rosenberg's instrumentality-value model, Fishbein's belief-evaluation model, and Beach's adaptation of subjective expected utility theory. Seventy female undergraduates rated each of the models' components and reported their attitudes and behavioral plans toward using three different methods of contraception. With the traditional across-subjects prediction procedure, the Rosenberg model generally accounted for 5-25% less variance in subjects' attitudes and behavioral plans than the Fishbein an Beach models, which were not different. With a within-subject prediction procedure, the Rosenberg model was again the least accurate, and the Fishbein and Beach models had similar predictive accuracy. As hypothesized, within-subject predictions were more accurate than across-subjects predictions. The relatively poor performance of the Rosenberg model was attributable to the instrumentality component. In addition, we found that the Beach model could be simplified with no appreciable loss in predictive accuracy. Finally, a subject's personal normative beliefs emerged as a strong independent predictor of behavioral plan.

Adult↗
PubMed1999

Contraceptive status and sexual behavior in women over 35 years of age in India.

The aim of this paper is to survey the current contraception use and analyze the sexual patterns in women above 35 years of age in India. Five hundred women, of whom 250 were at least 35 years old and 250 were less than 35 years old (control group) were interviewed with the help of a prepared questionnaire. A permanent surgical method of contraception had been accepted by 40.4% of women > or = 35 years old versus 16.8% of women < 35 years old. Of various temporary methods, an intrauterine device (IUD) was used by 5.2% and 22.8% oral contraceptive pills (OCs) by 1.2% and 9.6%, and natural methods by 6.4% and 3.2%, in women > or = 35 years and < 35 years, respectively. No contraception was used by 25.6% women > or = 35 years. A history of medical termination was given by 67.18% of non-contraceptive users vs. 27.41% of contraceptive users in women > or = 35 years. Coital frequency was noted at 4.32 times/month in women > or = 35 years but 7.2 times/month in women <35 years. Among contraceptive users > or = 35 years, coital frequency was 4.9 times/month compared with 3.9 times/month in non-contraceptive users. There is a high acceptance of irreversible sterilization and a high abortion rate in women > or = 35 years. Use of contraceptives was linked with increased sexual activity and a decreased abortion rate.

Abortion, Induced↗
PubMed1988

[Experiences with the sympto-thermal method of family planning].

Evaluation of 2,276 cycles in 439 patients who had been employing the double-check family planning method described by Thyma. The average length of the hyperthermic phase was 12 days. A tendency to longer hyperthermic phases was recorded in case of cycles of longer duration. In 74% of all cycles, the mucus peak was observed 1 to 3 days previous to the temperature rise. In 2,242 cycles, 3 pregnancies occurred which had not been planned, which corresponds to a Pearl index of 1.6. The temperature curves originally evaluated according to Thyma's criteria, were also assessed according to Roetzer's criteria. This analysis yielded 89.8% evaluable temperature curves according to Roetzer, in contrast to 77.8% evaluable curves according to Thyma. An additional disadvantage when using the "coverline" as suggested by Thyma, is the shortening of the post-ovulatory infertile phase which may occur occasionally.

Adult↗
PubMedDate not supplied

Contraceptive failure of the ovulation method of periodic abstinence.

Previously published estimates of probabilities of method and user failure for all contraceptive methods suffer from a serious methodological error and are biased downward, with the extent of bias unknown. Data from a World Health Organization clinical trial of the ovulation method of periodic abstinence were used to provide the first correctly calculated measures of method and user efficacy and to determine the characteristics that distinguish women who consciously take risks from those who do not. Probabilities of pregnancy during the first year are 3.1 percent during perfect use (method failure) and 86.4 percent during imperfect use (user failure). Thus, if used perfectly, the ovulation method is very effective. However, it is extremely unforgiving of imperfect use. Because perfect compliance is difficult for many couples who desire intercourse when it is forbidden by ovulation method rules, and because the risk of pregnancy during imperfect use is so great, the ovulation method cannot be considered an ideal contraceptive method for the typical couple, who are likely to be less compliant than couples who volunteer for a clinical trial. The probability of an accidental pregnancy is greatest when any of the three most serious rules--no intercourse during mucus days, within three days after the day of peak fecundity or during times of stress--are broken. Those who have a poor attitude toward the rules are more likely to take risks, including serious risks. Those who get away with taking a risk (i.e., do not get pregnant) are very likely to take risks again. Because breaking the most serious rules entails a 28 percent risk of pregnancy per cycle, those likely to take risks should be counseled about the probable consequences.

Adult↗
PubMedDate not supplied

Alternatives to vaginal intercourse practiced during the fertile time among calendar method users in Ireland.

A pilot study was conducted in Ireland to test the effectiveness of the calendar method of contraception. A conservative rule was used, requiring on average 16 days of abstinence per cycle. Among the 19 couples who entered into the study and were followed for up to seven cycles, there were no pregnancies. Since the length of abstinence was relatively long, we collected data to determine how couples expressed love and affection towards each other during those days when the woman was potentially fertile. We also collected data about barrier method use during the fertile time. We found that almost all couples gave each other hugs and kisses to show affection although couples were taught to abstain from vaginal intercourse during the fertile time. About one-third of the couples avoided genital contact, while about half reported using oral sex and/or frottage (body rubbing). Twice as many men reported using masturbation compared to women, although about half of the couples practiced mutual (partner) masturbation. In addition, about one-fifth of the couples used condoms during the fertile time in some cycles. These findings show that a variety of sexual expressions are used by couples when vaginal intercourse is to be avoided. Knowledge about these alternative sexual expressions may be important for couples who wish to engage in sexual activity and to avoid pregnancy.

Coitus↗
PubMed1989

Plasma reduced and total ascorbic acid in healthy women: effects of smoking and oral contraception.

This is the first report of both reduced (RAA) and total (TAA) plasma ascorbic acid levels in women who smoke and are on oral contraception. 155 normal healthy subjects were investigated. A study questionnaire was completed including age, method of contraception, smoking status, and food intake at breakfast, prior to attending the clinic. Biochemical assays were promptly carried out without knowledge of subject's clinical or dietary status. One-way analysis of variance revealed that oral contraception per se, barrier or IUD methods have no effect on plasma ascorbic acid levels. The mean values (mg/dl +/- SD) for plasma RAA between smokers and nonsmokers were 0.512 +/- 0.241 and 0.601 +/- 0.263; and that for TAA were 0.565 +/- 0.232 and 0.682 +/- 0.231, respectively. Significant decreases in both plasma RAA (p less than 0.05) and TAA levels (p less than 0.001) were observed in smokers. Age was an interacting variable. No association of smoking or oral contraceptive use was seen with RAA or TAA levels among women less than 26 years, but decreases in both RAA and TAA levels were evident among smokers aged 26 years or older. The present study emphasizes the total exposure to smoking, e.g., pack years, is a significant confounding variable in the study of plasma ascorbic acid levels.

Adolescent↗