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Trends in mortality from carcinoma of the liver and the use of oral contraceptives.

There is increasing concern that contraceptive pill usage may increase the risk of hepatocellular carcinoma. As primary malignant liver cancer is very rare in this country, any effect due to oral contraceptives should be apparent in national mortality statistics. An analysis of mortality rates over the last 24 years shows a small but consistent increase for young women starting to occur during the end of the last decade. However no such trend is apparent in data from other countries where pill usage is comparable to that in the U.K. Overall liver cancer remains an extremely uncommon cause of death in developed countries, but it will be particularly important to monitor trends in this disease in the future.

Adult↗

Acceptability of drugs for male fertility regulation: a prospectus and some preliminary data. World Health Organization Task Force on Psychosocial Research in Family Planning.

Hormonal substances for male fertility regulation administered orally or by injection are currently undergoing clinical evaluation. These trials, sponsored by the World Health Organization, provide unique opportunities for intensive study of the acceptability of such an approach to fertility regulation, and of these drugs in particular. The research employs repeated interviews over a 15-month period and is conducted by social scientists collaborating with biomedical scientists at each of seven sites (Bangkok, Hong Kong, London, Mexico City, Santiago, Seoul, and Toronto). The focus is upon gauging male user's evaluations of hormonal methods (several androgen/gestagen combinations as well as cyproterone acetate) relative to their evaluations of other male methods they know about or have experienced. Of particular importance is to determine whether the hormonal methods modify or interfere with sexual desire, feelings, and behavior. The research is also assessing specific ways in which various perceived properties of fertility regulating methods relate to their acceptability in different socio-cultural settings.

17 alpha-Hydroxyprogesterone Caproate↗

Trends in the use of oral contraceptives among Dutch young women 1975-1981.

Prompted by a recent report of a decrease in the use of oral contraceptive in the U.S.A., we investigated the trends by age and time of oral contraceptives use among Dutch young women, born between 1955 and 1970. They participated in a follow-study of risk-indicators for cardiovascular disease. A random sample of 596 subjects, initially aged 5-19, and selected from an open population, was invited for annual exams since 1975; 462 youngsters (226 girls) underwent at least three annual exams. They were asked each year whether they used oral contraceptives. Analysis of the trend by age showed an increase of the proportion of oral contraceptives users from less than 5% at an age of 15 to about 50% at 23 years of age. In the 1959-1962 birth cohort, the proportion of users was twice as large as that of the 1955-1968 cohort. The 1963-1966 cohort followed the pattern of the 1959-1962 birth-cohort. These findings indicate that there has been a strong increase in the use of oral contraceptives among Dutch women born after 1958. We found no evidence for a recent decrease in the use of oral contraceptives in the Netherlands among young women.

Adolescent↗

A multicenter clinical trial of a progestin-only oral contraceptive in lactating women.

A non-comparative study of a progestin-only oral contraceptive (POC) containing 75 micrograms norgestrel was conducted at 22 sites in 14 countries. This study was designed to evaluate safety, contraceptive efficacy, and the overall acceptability of a POC in breastfeeding women. A total of 4,088 women entered the study over a three-year period and 29,399 woman-months of experience was gathered. Women had follow-up visits at 2, 6, and 11 months after admission. Headaches and vaginal discharge were the medical complaints most commonly reported by women, both prior to and after admission. Menstrual problems were reported by 59% of the women after admission. Of the 3,714 women who returned for at least one follow-up visit, 1,101 (29.6%) discontinued through month 11. The 11-month total discontinuation percentage, including those lost to follow-up (25.3%) was 51.6%. The most common reason given for discontinuation was a woman's desire for a change in contraceptive method. Only 4.9% discontinued pill use for menstrual problems, a percentage far below those generally reported for POCs. Twenty-nine unintended pregnancies occurred through 11 months giving a gross cumulative life table rate of 1.2 per 100 women (Pearl Index = 1.4). The POC appears to be a safe, effective and acceptable contraceptive option for postpartum breastfeeding women.

Adolescent↗

[Psychosomatic aspects of oral contraception].

Oral contraceptive use is influenced by multiple emotional factors. Physiological and psychological effects are closely correlated. Contraception may assist women in pursuing important psychosocial goals, on the other hand, it may cause a number of problems. Many unconscious wishes or fears may interfere with the clear separation of sexuality from fertility. Ambivalence about pregnancy, neurotic personalities and problems in partner relationship may cause psychic conflicts with regard to contraception. Anxiety, side effects, misuse of contraceptives or problems in the relationship between doctor and patient may result. As a further development psychosomatic symptoms such as discomfort, nervousness, sleep disturbance, fatigue, nausea and sexual disorders may appear. The physician must take contradictory feelings of the patient into consideration, including her anxiety and her possible ambivalence with respect to pregnancy.

Contraceptives, Oral↗

Evaluation of Committee on Safety of Medicines yellow card reports on oral contraceptive-drug interactions with anticonvulsants and antibiotics.

1. We have searched the adverse reactions register for the years 1968-84 in an attempt to evaluate data relating to reported pregnancies in women on oral contraceptive steroids (OCS) who concurrently received either an antiepileptic drug or an antibiotic. 2. A total of 43 pregnancies were reported in women on OC therapy who concurrently received antiepileptic drugs and 63 pregnancies in women receiving antibiotics. In addition the number of prescriptions for both antiepileptics and antibiotics in England are reported for the years 1973-84.

Anti-Bacterial Agents↗

An open assessment of a new low dose oestrogen combined oral contraceptive.

This was a multicentre general practitioner study using a new low dose oral contraceptive, Ovamin 30 (ethinyloestradiol 30 microgram, ethynodiol diacetate 2 mg). Results showed a pregnancy rate calculated as a Pearl Index of 0.4. An analysis of bleeding patterns showed consistently acceptable cycle control. From these results it would appear that Ovamin 30 is an effective and well tolerated low dose oral contraceptive preparation.

Contraceptives, Oral↗

The female condom. A pilot study of the acceptability of a new female barrier method.

The best available prevention against sexually transmitted diseases is limited to a consistent and correct use of a condom by the male. A new barrier method has been developed for the female. As it can be inserted into the vagina before sexual intercourse starts, and as it covers the entrance of the vagina, the opening of the urethra and the root of the penis, it is presumed to give a high degree of protection against sexually transmitted diseases and unwanted pregnancy. The preliminary results concerning acceptability are promising, and further investigations concerning acceptability and efficacy are in progress or completed in several countries. The method should be regarded as one aspect in the pattern of protection, particularly suitable for females with sexual risk behavior.

Adult↗