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PubMed2000

New contraceptive methods.

As the number of abortion procedures performed each year reaches nearly 1 million, the incentive to decrease the incidence of unwanted pregnancy in the United States is high. Better education regarding women's health issues and enhanced contraceptive development are necessary to impact this long-standing problem. Several new contraceptive products are likely to become available in years to come to increase the number of choices that women and their health care providers have for pregnancy prevention. These products include long-acting implants, the levonorgestrel intrauterine device, patches, and the vaginal ring. This article surveys the near future of male and female contraception.

Administration, Cutaneous↗
PubMed2003

Barrier contraceptive method acceptability and choice are not reliable indicators of use.

BACKGROUND: The need for safe and effective female-controlled methods that protect against sexually transmitted pathogens is widely recognized. Product effectiveness is inextricably bound to use, and, therefore, the needs and preferences of potential consumers must be considered. The degree to which measures of acceptability correlate with actual barrier method use remains unexamined. GOAL: The goal was to evaluate associations between measures of acceptability and use of existing over-the-counter barrier methods. STUDY DESIGN: In the San Francisco Bay Area, 510 females aged 15 to 30 years were recruited from reproductive health clinics for this longitudinal study. RESULTS: Neither hypothetical acceptability nor product choice predicted use. Fewer than 50% of participants who chose a female-controlled method used it. Similarly, method satisfaction was not associated with use (14.3-51.4% of satisfied users used the method again). However, dissatisfaction was predictive of low levels of subsequent use (0-15.3% used the method again). Male condoms were used despite dissatisfaction. CONCLUSION: The lack of association among assessments of acceptability, choice, satisfaction, and use suggests a need to reframe how product acceptability is evaluated in prevention research so it is more predictive of method use.

Adolescent↗
PubMed1996

Contraceptive method and condom use among women at risk for HIV infection and other sexually transmitted diseases--selected U.S. sites, 1993-1994.

A primary strategy for decreasing the spread of human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs) is to increase the rate of condom use among at-risk persons, and an important approach for reducing unintended pregnancies is to increase the use of effective contraception. Some women are at risk for both STDs and unintended pregnancy and require a highly effective strategy for protection against both risks. To assess the association between condom use at last intercourse and use of specific methods to prevent pregnancy among women at risk for HIV infection and other STDs, project investigators analyzed data from the Prevention of HIV in Women and Infants Demonstration Project. This report presents the findings of the analysis, which indicate that many women who were potentially well protected against pregnancy were underprotected against STDs.

Adolescent↗
PubMed2005

The relationship between males' attitudes to partner violence and use of contraceptive methods in Turkey.

Interventions have been carried out to improve the reproductive health and status of women in Turkey. However, these efforts are limited due to lack of male involvement. Lifestyle risks such as partner violence need to be evaluated in terms of any effects on the use of contraception. Data collected from interviews of married women and their husbands for the 1998 Turkish Demographic and Health Survey and 1971 husbands were included in the study. The percentage of husbands who were against partner violence was 20.4%. However, 22 (0.9%) husbands had an attitude toward the use of violence against their wives. The frequency of contraceptive use was increased from the group of men who had unfavorable attitudes towards violence to the group of men who had favorable attitudes. A similar trend was found in the percentages of condom use for men, with multiple factors influencing contraceptive use. The study suggests that further investigations are needed for couple-related issues to improve the status of women in the community and to empower women for sexual health.

Adolescent↗
PubMed2004

Contraceptive methods and induced abortions and their association with the risk of colon cancer in Shanghai, China.

267400 female textile workers in Shanghai, who were administered a questionnaire at enrollment into a randomised trial of breast self-examination between October 1989 and October 1991, were followed up until the middle of 2000. Based on the 655 women who developed colon cancer, rate ratios (RRs) were estimated and trends in risk assessed using Cox Proportional Hazards Models. Risk was increased in women who used oral contraceptives for over 3 years (RR=1.56, 95% Confidence Interval (CI) 1.01-2.40). A possible increase in risk was also observed in women who received progestational injections during pregnancy (RR=1.24, 95% CI 0.95-1.62), but not in relation to the use of injectable contraceptives. A possible reduction in risk was associated with tubal ligation (RR=0.86, 95% CI 0.71-1.03) and ever having had an induced abortion (RR=0.84, 95% CI 0.71-1.00). No trends in risk were observed in relation to the duration of hormonal contraceptive use or the number of induced abortions. Additional studies of the possible roles contraceptives may play in the aetiology of colon cancer in women at low risk of this disease are warranted.

Abortion, Induced↗
PubMed2006

Preferences between injectable contraceptive methods among South African women.

OBJECTIVE: To examine South African women's preferences between depot medroxyprogesterone acetate (DMPA) and norethisterone enanthate (NET-EN), as well as the reasons for and correlates of these preferences. STUDY DESIGN: A cross-sectional study among women attending 26 primary health care clinics across the Western Cape Province. RESULTS: Of 893 women participating in the survey, 57% (n=511) and 45% (n=399) had ever used DMPA and NET-EN, respectively. Among women who knew of both injectables, 46% stated a preference for DMPA (n=365) and 37% stated a preference for NET-EN (n=297). Most women who preferred DMPA thought that it was more effective in preventing pregnancy, while women who preferred NET-EN stated that it was preferable for women who wanted children in the future. Preferences for NET-EN were independently associated with younger age, higher education and living in an urban area. CONCLUSION: These findings suggest that there are significant misperceptions among women regarding the differences between DMPA and NET-EN, which may have important resource implications for contraceptive services. It is likely that these misperceptions arise from popular discourse and individual user experiences, as well as poor communication with and counseling of women on the part of providers. Interventions aimed at both users and providers are required to dispel the myths and misinformation regarding progestogen-only injectable methods.

Adolescent↗
PubMed2000

[The interplay between embryo and endometrium is important for successful implantation. Increased knowledge can result in new contraceptive methods and better treatment of infertility].

It seems likely that local factors such as cytokines play an important role in synchronizing the development of the embryo and the gestational tract and in determining pregnancy outcome. Evaluation of the precise sequence of cytokines to which the embryo is exposed and responds during the critical periimplantation period may also make it possible to develop culture media which will improve embryo viability and hence increase implantation rates in IVF programs. In addition, an in vitro three-dimensional culture system is being developed which closely resembles endometrium in vivo. This system offers an opportunity to study the local molecular events involved in blastocyst adhesion and to elucidate the role played by local factors, such as cytokines, in producing a receptive luminal epithelium.

Blastocyst↗
PubMed1999

The use of nonhormonal methods of contraception in adolescents.

Although the 1990s have seen a reduction in unintended pregnancy rates and improved contraceptive-use rates, the negative consequences of unintended pregnancy and STD acquisition continue to plague our youth. Primary health care providers, including pediatricians, play an essential role in further reducing unintended teen pregnancy and STD acquisition rates through the promotion of effective and consistent contraception. Pediatricians need to be aware that now, more than ever, nonhormonal contraceptive methods should be used by every sexually active youth, and counseling of both boys and girls should be routine. Although not as effective at preventing pregnancy as hormonal methods of contraception, many nonhormonal methods provide excellent STD protection. Condoms plus spermicide continue to be a very popular and effective method of pregnancy and STD prevention. The newer polyurethane male and female condoms provide alternative, safe barrier protection, although their efficacy at preventing HIV in vivo needs further study. Diaphragms and cervical caps, in conjunction with spermicide, also provide pregnancy and STD prevention, but not as effectively as male condoms plus spermicide. Although most likely to use condoms in association with another birth control method, adolescents often find dual-method use cumbersome and difficult to comply with. Finally, although IUDs and periodic abstinence are safe methods of birth control for older women in monogamous relationships, they are unlikely to be appropriate for most adolescents. In many respects, we have come full circle back to our "nonhormonal contraceptive roots." As we enter the twenty-first century, we have found that no single "miracle" approach can be used to reduce adolescent pregnancy and STD rates. Rather, pediatricians are obliged to offer nonhormonal methods of contraception, often in conjunction with other birth control methods, as a means of preventing unwanted STDs and pregnancy. Through a comprehensive community approach that uses sex education, abstinence programs, condom-availability programs, and contraceptive-skills training, however, pediatricians can play a central role in the promotion of effective and consistent contraception by adolescents.

Adolescent↗
PubMed1989

Vasectomy as a contraceptive method.

The paper reports a series of 1,000 consecutive vasectomies, mostly self referrals, performed at a family planning clinic. Comprehensive counseling was a mandatory prerequisite, the average time spent considering vasectomy prior to counseling was 22 months. The couples characteristics were as follows: age 30-39 years, married 11.3 years, with 3.4 children, upper social class preponderance. To minimise the risk of recanalisation (0.2%), 20 mm of vas deferens was resected. In the early part of the series, inflammatory tissue reaction due to slow absorption of synthetic suture posed a minor problem which was subsequently eliminated by use of a soft gut variety. The majority (99%) was pleased with the procedure and did not suffer complications. One per cent experienced some psycho-sexual problems such as decreased libido, ejaculatory problems, depression. Based on data collected from other centres we estimate that 3,303 sterilizations were performed in Ireland in 1986 with a male:female ratio of 3.2.

Contraception↗