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PubMed1985

Development of a decision aid for women choosing a method of birth control.

The choice of a contraceptive method is complex and difficult. This study identifies issues for concern for women in selecting a birth control method, examines the accuracy of a self-administered questionnaire based upon these outcomes in predicting actual use, and in a preliminary fashion evaluates the usefulness of such an instrument as a decision aid. A questionnaire was designed to assess women's perceptions of the likelihood of each issue of concern for four birth control methods--oral contraceptives, intrauterine device (IUD), diaphragm, and foam or condoms--as well as the relative value of each issue. It was then tested among a convenience sample of 106 women. A weighted score was constructed by combining likelihood and value estimates for each contraceptive method. The method with the highest score was compared with actual contraceptive use and the intention to use such methods in the future. Positive predictive values were highest for pill use (83 percent) and lowest for IUD use (40 percent). While 65 percent of the sample were satisfied with their current method, 60 percent also found the questionnaire helpful. This attitude was most prevalent among younger, unmarried women. A decision aid for contraceptive decision making appears to be reasonably predictive of actual contraceptive use and helpful in thinking about the choice of a birth control method.

Adolescent↗
PubMed1981

[Side effects of hormonal contraception].

Female sex hormones have an influence not only on the reproductive process, but on nearly all organs and functional systems. This explains their broad spectre of side-effects, which by their degree of subjective annoyance may impair the acceptability of hormonal contraception or--through a suggested risk to the patient--even enforce discontinuation of medication. The significance of quite a number of alterations in biochemical and metabolic parameters cannot yet be fully elucidated. The author offers a summary of the principal side-effects of present-day hormonal contraceptives.

Abortion, Spontaneous↗
PubMedDate not supplied

Pill and IUD discontinuation in the United States, 1970-1975: the influence of the media.

Analysis of the 1975 National Fertility Study data on pill and IUD discontinuation shows an upward trend in discontinuation rates for both methods between 1970 and 1975, with particularly sharp increases in pill discontinuation starting in 1972. Almost 40 percent of pill discontinuation was attributable to problems of use; three-fifths of these problems were physical. About one-quarter of pill discontinuation was for reasons other than problems of use. The single most common of these was that the woman wanted to become pregnant. Almost 40 percent of IUD discontinuation was due to method-related problems; only 13 percent was due to the women's desire to become pregnant, a finding which suggests that women do not use this method for childspacing. Examination of the relationship between pill and IUD discontinuation and unfavorable news stories about these two methods reveals that after specific news events, discontinuation rates for both methods tend to increase. Rates climb for 5-6 months following specific unfavorable news stories, with peaks in the rate of change in discontinuation reached 3-5 months after a pill-related story and 2-4 months after an IUD-related story. General media coverage of the adverse effects of pill use in particular (where general coverage is defined as the cumulative number of pill articles appearing between 1970 and 1975) accounts for 34 percent of the variance in pill discontinuation rates. This correlation is strongly suggestive of a causal relationship between general mass media coverage of the adverse effects of the pill and discontinuation rates for this method.

Contraceptives, Oral↗
PubMed1984

Alteration of platelet responses to metabolites of arachidonic acid by oral contraceptives.

The effects of oral contraceptive (OC) usage on platelet responsiveness to arachidonic acid metabolites was investigated. Platelets obtained from women who had been taking oral contraceptives for at least 3 months were compared with those of age-matched controls. Both the basal and prostacyclin (PGI2)-stimulated platelet cAMP levels were significantly lower in OC users than in non-users. There was no significant difference in the PGD2-stimulated cAMP levels between the two groups. Furthermore, platelet aggregability to U46619, a TXA2 agonist, was greatly enhanced by OCs. Our data suggests that OC usage can specifically enhance platelet responsiveness to TXA2 while suppressing platelet responsiveness to PGI2. Thus their overall effect would be a disruption of normal platelet responses in favour of thrombus formation.

15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5↗
PubMed2000

Effects of hormonal contraceptives on the periodontium, in a population of rural Sri-Lankan women.

AIMS: Women using hormonal contraceptives can be considered to be a 'risk group' for periodontal disease, due to prolonged, sustained serum levels of oestrogens and progesterone. This investigation aims to study the effects of hormonal contraceptives on periodontal tissues. METHODS: 32 women using hormonal contraceptives for less than 2 years, 17 for 2-4 years and a matched control group of 39 non-users were selected for the study. They were clinically examined for plaque levels (plaque index: PLI), gingival condition (gingival index: GI) and loss of periodontal attachment (LA). RESULTS: Contraceptive users of less than 2 years and 2-4 years duration (n=32, n= 17 respectively) and non-users (n=39) had similar oral hygiene levels; yet the contraceptive users had a significantly higher level of gingival inflammation, compared to the non-users (p<0.001; 1-way ANOVA). Usage of hormonal contraceptives for 2-4 years (n= 17) caused a significantly higher LA (p<0.001) compared to that of controls (n=39). CONCLUSIONS: Usage of contraceptive preparations containing oestrogen and progesterone resulted in hormonal changes similar to those seen in pregnancy, associated with increased prevalence of gingivitis. There was significantly higher LA with prolonged usage of hormonal contraceptives, compared with controls.

Adolescent↗
PubMed1994

Introducing the low-dose pill to Bangladesh; issues of continuation and failure.

In response to government plans to introduce a low-dose pill to the national family planning program of Bangladesh, a comparison of the performance of low-dose and standard-dose pills among a rural Bangladeshi population was conducted. Continuation rates were found to be better among users of the low-dose pill and there was no evidence that failure rates were higher. The relative risk (standard-dose vs. low-dose) over the first 30 months following adoption was 1.25 for first method continuation, and 1.29 for extended use failure. This paper, thus, provides evidence that low-dose pills may be a suitable method of contraception for rural Bangladeshi women.

Adult↗
PubMed1980

Oral contraceptives and birth defects.

This report compares the history of oral contraceptive (OC) use for 715 New York state women who gave birth to malformed infants with the history for a group of 715 matched controls who gave birth to normal children. The case mothers were found to have used the OC after last menstrual period (LMP), or just before conception, slightly more often than the controls. Confidence intervals for the relative risk estimates were wide, and were significantly higher than 1.0 only among the group of women whose children had one or more major structural or anatomical malformations. Cytogenetic abnormalities and hypospadias were not associated with OC use around or after the time of conception. For women who had children with major anatomical or structural malformations, the association with OCs was stronger among the older age group. The authors found no evidence of an increased risk among women who had conveived their child after one or more pill-free menstrual cycles. Several reported studies, including this one, show a predominance of males among malformed offspring whose mothers used OCs during pregnancy. These findings indicate that the association between birth defects and OC use around the time of conception is not large, but the association is not easily reconciled with a non-causal explanation.

Abnormalities, Drug-Induced↗