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Results for “Contraception Continuation”

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PubMed2003

Continuous use of oral contraceptives reduces bleeding.

This study provides good evidence that continuous use of combination oral contraceptives for 1 year decreases bleeding without clinically important changes in blood pressure, weight, or hemoglobin when compared with cyclic users. Clinicians should consider offering this option to their patients, while continuing to look for evidence that addresses long-term sequelae, as well as patients of color or those with less than a college education.

Comment↗
PubMed1980

Assessment of family planning service delivery in Egypt.

The Arab Republic of Egypt has used family planning service delivery as the main vehicle for implementing its national family planning policy since 1965. This paper reports results of a study undertaken during 1975-77 using a systematic sample of 100 health units offering family planning services in two governorates of Egypt. The findings suggest that there is considerable potential for improving the service delivery system through better management. Broadening the choice of technology offered, increasing the quantity and quality of outreach and communication activities for new and continuing contraceptors, and improving staff availability could lead to improvements in national program participation and continuation.

Contraceptive Agents↗
PubMed1980

The use of a modified copper intrauterine device in nulliparous women with small uterine axial length.

In a preliminary study a highly selected group of 31 nulliparous patients with uterine axial length less than 6 cm underwent 32 insertions of a modified Gravigard device with reduced vertical and horizontal arms. After at least six months of use 26 patients (81%) continued to use this method of contraception. The six patients who discontinued are accounted for as follows: one became pregnant, two expelled the device, two requested removal of their devices because of pain and bleeding, and one device was removed accidentally. There was one further pregnancy at nine months of use. It is concluded that provided that the dimensions of the Gravigard are reduced, it is an acceptable method of contraception in nulliparae with small uterine axial length.

Adolescent↗
PubMed1983

Menstrual bleeding expectations and short-term contraception discontinuation in Mexico.

This study tests the hypothesis that women will be more likely to continue a contraceptive if their expectations about changes in bleeding and discomfort are accurate. The study examined the relationship between women's expectations and discontinuation rates for IUD and pill acceptors over a three-month interval. The results show that attitudes and expectations are as important as actual changes in accounting for contraceptive discontinuation among pill users; the results for IUD users are not as clear. It is recommended that family planning programs make it a priority to inform women about the changes in their bodies that can be caused by contraceptives in order to reduce high rates of discontinuation.

Adult↗
PubMed1992

Long term use of inert intrauterine contraceptive devices in 94 women in Israel.

A 22 year retrospective survey was undertaken in an Israeli family practice to determine how long inert (plastic only, unmedicated) intrauterine contraceptive devices could be safely left in place. Ninety four women were identified who had used 100 inert intrauterine contraceptive devices continuously for between five and 19 years. Fifty nine women complained of pain, increased uterine bleeding or increased vaginal discharge, but these were the reasons for removal of the device in only 32 women. There was only one case of pelvic inflammatory disease but this was treated without removal of the intrauterine contraceptive device. Of 14 women who requested to have their device removed after between five and nine years without having had any side effects, 11 women conceived within nine months. The results of the study indicate that inert intrauterine contraceptive devices can be safely left in place until the menopause. As it will take many years before the new type of copper devices can be shown to be as safe for long term use, it seems an appropriate time to reintroduce inert intrauterine contraceptive devices for women.

Adolescent↗
PubMed1989

[Disseminated peritoneal leiomyomatosis. A rare disease picture].

After taking oral contraceptive hormones continuously for 17 years, a 44 year old patient developed enlarging uterine leiomyomas and multiple small to tiny subperitoneal nodules throughout the pelvic peritoneum. Histologically and immunohistochemically, the nodules proved to be leiomyomas. Similar nodules were induced in young female guinea pigs by injecting them with estradiol twice weekly. The first nodules appeared after four months. Approximately 50 cases of Leiomyomatosis peritonealis disseminata (LPD) have been reported to date in the world literature. Of these, 23 patients were pregnant. Seventeen had taken oral contraceptives continuously for many years (from 8-17). The developing leiomyomatous nodules probably arise from the Müllerian epithelium, which is distributed throughout the subperitoneal mesenchyme. By appropriate individual predisposition and excessive hormonal stimulation, the Müllerian derivatives proliferate along lines of myofibrous differentiation. Since the oral contraceptives all contained in addition to estradiol the synthetic gestagen norethindrone (or lynestrenol) and since these same hormones led to identical tumor nodules in animal experiments, it seems to suggest, that the stimulation of the Müllerian epithelium results from a specific combination of hormones. A similar combination of hormones may develop endogenously during a hormonally disturbed pregnancy. To prove these assumptions, larger case and interdisciplinary studies are needed. It is of clinical importance to realize, that the dormant Müllerian epithelium may be stimulated by excessive hormones to proliferate and that the proliferations produced, such as the benign nodular tumors of LPD, must be differentiated from nodular metastases of malignant tumors.

Adult↗
PubMed1993

A five-year clinical evaluation of Norplant contraceptive subdermal implants in Bangladeshi acceptors.

A non-comparative study of the Norplant contraceptive subdermal implant system was conducted in Dhaka, Bangladesh. The study was designed to evaluate the contraceptive efficacy, safety and overall acceptability of Norplant implants. Six hundred women were enrolled in the clinical trial, which began in 1985 at three study sites. Follow-up visits were scheduled at 1, 3, and 6 months after Norplant implant insertion, and every six months thereafter until removal or at the end of five years. There were no post-insertion pregnancies during Norplant implant use in this study. After five years of Norplant implant use, there was no clinically significant change in body weight, systolic or diastolic blood pressure. Less than 3% of the women ever reported having any significant medical problems such as migraine, respiratory or cardiac problems during the study. The gross cumulative continuation rate was 41.2 per 100 women at the end of five years. The two most frequently reported reasons for discontinuation during the study were menstrual problems and desired pregnancy. Of the women who completed the five-year user satisfaction questionnaire, the majority of the women (86.3%) planned to continue using contraception after study completion. Of these women, approximately one-third said they planned to use another Norplant set. The findings presented suggest that the Norplant system is a highly effective, safe and acceptable method among Bangladeshi women.

Adolescent↗
PubMed1999

Comparison of continuation rates for hormonal contraception among adolescents.

BACKGROUND: Inadequate contraception is common among sexually active female adolescents, resulting in a high incidence of unwanted pregnancy. The authors were interested in comparing continuation rates for the different forms of hormonal contraception in this age group. METHODS: A retrospective chart review. The setting was an urban clinic in a large Midwestern city. Participants were 64% black, 34% white, and the average age was 15.5 years (+/- 1.6 SD), with implant users significantly older than oral contraceptive pill (OCP) users (P < .05). Interventions were self-selection to depo-medroxyprogesterone acetate (Depo-Provera; DMPA), levonorgestrel implants (Norplant), or oral contraceptive pills (OCPs). Previous pregnancy was significantly more prevalent in implant and DMPA users than in OCP users (P < .001). Over 4 years of follow-up, continuation rates were significantly higher for implant users than for the other hormonal groups (P < .001). At 1 year, continuation rates were as follows: 82% implants, 45% DMPA, and 12% OCPs. Combining these rates with those of the subsample who switched without interruption to another hormonal method, "continued protection" rates were much higher after 1 year: 96% implants, 83% DMPA, and 49% OCPs. Calculations of contraceptive "restarts," i.e., hormonal method use in those who discontinued and then restarted after a gap of time, also increased to the prevalence of contraceptive protection. CONCLUSION: Continuation rates for levonorgestrel implants were significantly higher than those for DMPA and OCPs, the latter group having the lowest continuation rates. Factoring in switches and restarts to other hormonal methods further boosted the prevalence rates of contraceptive use in the adolescent population.

Adolescent↗
PubMed2006

Number of oral contraceptive pill packages dispensed, method continuation, and costs.

OBJECTIVE: To estimate the effect of the number of cycles of oral contraceptive pills (OCPs) dispensed per visit on method continuation, pill wastage, use of services, and health care costs. METHODS: We used paid claims data for 82,319 women dispensed OCPs through the California Family PACT (Planning, Access, Care, and Treatment) Program in January 2003 to examine contraceptive continuation and service use. RESULTS: Women who received 13 cycles at their first visit in January 2003 received 14.5 cycles over the course of 2003 compared with 9.0 cycles among women receiving three cycles at first visit. When client characteristics are controlled, women who received 13 cycles were 28% more likely to have OCPs on hand and twice as likely to have sufficient OCP cycles for 15 months of continuous use compared with women who received three cycles. Oral contraceptive pill wastage was higher among women initially dispensed 13 cycles (6.5% of the cycles dispensed) than among women who received three cycles (2% of cycles). Despite having one fewer clinician visit, women dispensed 13 cycles were more likely to receive Pap and Chlamydia tests and less likely to have a pregnancy test than women initially dispensed fewer cycles. Over the course of the year, Family PACT paid 99 US dollars more for women who received three cycles and 44 US dollars more for women who received only one cycle than it did for women who received 13 cycles at their first visits of 2003. CONCLUSION: Dispensing a year's supply of OCP cycles to women is associated with higher method continuation and lower costs than dispensing fewer cycles per visit. LEVEL OF EVIDENCE: II-2.

Adult↗
PubMed2001

The debate regarding continuous use of oral contraceptives.

OBJECTIVE: To determine whether oral contraceptives (OCs) can be used safely in a continuous manner to prevent monthly withdrawal bleeding. DATA SOURCES: Search of MEDLINE (1966-2000), International Pharmaceutical Abstracts (1970-2000), and the Internet. DATA SYNTHESIS: Several prospective studies have assessed the efficacy of continuous cycle OCs in preventing monthly withdrawal bleeding. Monophasic OCs are useful for this purpose. In studies using traditional OC regimens as a control, patients receiving continuously administered OCs experienced more breakthrough bleeding and spotting. Continuous use of OCs decreased headache and other menstruation-associated symptoms. No long-term trials have assessed the impact of continuous use of OCs on risk of cancer, thromboembolic disease, or fertility, concems raised by opponents of the method. CONCLUSIONS: From the data available, continuous use of OCs is an effective method for delaying withdrawal bleeding. Long-term safety data are not available.

Adult↗
PubMed1992

Oral contraceptives and risk of benign proliferative epithelial disorders of the breast.

In a case-control study conducted in Adelaide, South Australia, we investigated the hypothesis that use of oral contraceptives is associated with increased risk of benign proliferative epithelial disorders (BPED) of the breast, conditions strongly associated with increased risk of breast cancer and thought to have pre-malignant potential. The study was restricted to women with no prior history of breast biopsy, and involved 383 cases of biopsy-confirmed BPED, 192 controls whose biopsy did not show epithelial proliferation, and 383 unbiopsied community controls individually matched to cases by age and socio-economic grading of area of residence. When cases were compared with community controls, the adjusted odds ratio (OR) for the association between ever-use of oral contraceptives and risk of BPED was 1.1 (95% CI 0.7 to 1.7), while when cases were compared with biopsy controls, the adjusted OR was 0.9 (95% CI 0.5 to 1.5). There was little variation in risk of BPED with total duration of use of oral contraceptives, and with duration of use before first pregnancy, while current users had a statistically significant 60% reduction in risk, irrespective of the control group used for comparative purposes. Also, there was little variation in risk with years since first and last use of oral contraceptives, and there was no trend in the association between ever-use of oral contraceptives and risk of BPED by degree of cytological atypia.

Adult↗
PubMed1991

Measuring contraceptive values: an alternative approach.

Previous assessments of individuals' values for various contraceptive consequences have employed one of four methodologies: free elicitation, direct ratings, multiple regression, or factor analysis. All four methodologies are flawed because they produce group rather than individual values, relying on rating scales, and fail to incorporate information regarding consequence trade-offs. Axiomatic conjoint measurement is proposed as an alternative methodology and used to determine individuals' values for a selected set of contraceptive consequences at two stages of the family-planning career.

Attitude↗