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PubMedDate not supplied

[Contraceptive practices among adolescents and youths of the metropolitan area of Mexico City].

The purpose of this article is to provide a brief description of the information that the adolescent and youth population of Mexico City has concerning the knowledge and use of contraceptive methods, as well as the reasons why they do not adopt some contraceptive method during their sexual relations. The data obtained from the Survey on Adolescent and Youth Reproductive Behavior in the Metropolitan Area of Mexico City serves as a basis for pointing out several behavior patterns of the male and female population from 10 to 25 years of age. Of those interviewed, 32.7 per cent had had at least one sexual contact; the average age at which sexual relations had begun was 16 years for males and 17 for females. A total of 33.8 per cent of those who had had sexual contact stated that they had used some form of contraception, the principal methods used during first sexual intercourse being rhythm (36.9%); withdrawal (23.6%), and condoms (12.3%). The reasons for not using any contraceptive method were as follows: lack of knowledge regarding the methods, how to use them or where to obtain them (39.4%), and unplanned sexual intercourse (28.9%). During the last sexual contact they had, 70.5 per cent had used a contraceptive. The methods most frequently used were hormonal contraceptives and IUD (40.9%); rhythm (23.8%), and withdrawal and condoms. The reasons why no contraceptive was used in the last sexual contact were: neither partner thought that pregnancy would occur (27.1%) and the sexual contact was unplanned.

Adolescent↗
PubMed2006

The provision and funding of contraceptive services at publicly funded family planning agencies: 1995-2003.

CONTEXT: Publicly funded family planning agencies face significant challenges in delivering quality services to low-income women because of the higher costs of newer contraceptive methods, changes in health care financing and a growing uninsured population. METHODS: In 2003, 627 of a nationally representative sample of 956 U.S. agencies receiving public funding for family planning services responded to an eight-page survey. Responses were compared with results from similar surveys in 1995 and 1999 to describe changes in the availability of contraceptive methods, policies on method provision and funding issues. Variation was examined by agency type and Title X funding status. RESULTS: Between 1995 and 2003, the number of contraceptive methods available to women increased and agencies reduced barriers to oral and emergency contraceptives by liberalizing policies for their provision. By 2003, many agencies offered the newest contraceptive methods available-the progestin-only IUD (58%), the patch (76%) and the vaginal ring (39%). However, more than half of agencies did not stock certain methods because of their cost, and some key funding sources had declined. Between 1995 and 2003, the proportion of agencies receiving Medicaid funding fell from 91% to 80%, and the proportion of clients paying full fee for their contraceptive services fell from 19% to 14%. The share of agencies waiving fees for adolescents fell from 66% in 1999 to 44% in 2003. CONCLUSIONS: Continued funding challenges limit the ability of publicly funded providers to offer all available methods to all women.

Adolescent↗
PubMed1996

New hormonal methods of contraception.

Three types of new contraceptive delivery system have been discussed in this chapter. Each have novel methods of delivery and may be acceptable to certain groups of women. It is clear that subdermal contraceptive implants are extremely useful as a long-term method of contraception, and provided insertion occurs correctly, removal will then be easy. The second-generation implants using a single rod, compared with the first-generation ones using six capsules, would appear to offer advantages both to the patient and in relation to the training of medical and paramedical personnel who have to fit the subdermal implant. The main disadvantage is the incidence of irregular bleeding, which, by and large, can be overcome by pre-insertion counselling and by time. The second method of delivery, vaginal rings, offers high patient acceptability, but a usable ring for contraception has as yet to be developed. Two approaches appear to be the use of a continuous progestogen-only ring, or a combined ring releasing oestrogen and progestogen with a 21-day-in, 7-day-out cycle of use. Ongoing studies will indicate whether vaginal lesions are significant or related to the flexibility of the ring. If these studies prove satisfactory, further development of the vaginal rings, both as an alternative method for interval use or as a specific postpartum form of contraception using progesterone-releasing rings, will be developed. Significant developments in the use of a combined monthly injectable have led to the release of two preparations, Cyclofem and Mesigyna, which are now available in many countries. This combined approach offers a significant reduction in amenorrhoea rates and unacceptable bleeding, the majority of women having acceptable menstrual patterns even during the first 3 months of use. All three methods have low and acceptable rates of pregnancy, the lowest being seen with the subdermal implants and with combined monthly injectables. Due to the length of action of subdermal implants, these may find a niche for women wishing to use a long-acting method and not wishing to be sterilized. They also provide a useful method where medical intervention is not available on a regular basis. Monthly injectable preparations can be given by paramedical personnel, and introductory studies have indicated that in developing and developed countries, they are highly acceptable. All three methods offer an increased choice for women and safe and effective methods of contraception.

Administration, Intravaginal↗
PubMedDate not supplied

Contraceptive characteristics: the perceptions and priorities of men and women.

CONTEXT: Despite the fact that choosing a contraceptive method is often a decision made by couples, little is known about how men and women differ in their perceptions of the characteristics of various method types, and in the importance that they attach to those characteristics when choosing a contraceptive method. METHODS: The data analyzed here are subsets from two companion surveys conducted in 1991--1,189 men aged 20-27 who were surveyed in the National Survey of Men and 740 women aged 20-27 who were surveyed in the National Survey of Women. Multivariate ordered logit analysis is used to examine how gender is related to both the importance that individuals assign to seven specific contraceptive characteristics when choosing a method, and to perceptions about the extent to which five common method types possess each of these characteristics. RESULTS: Women rank pregnancy prevention as the single most important contraceptive characteristic when choosing a method, with 90% citing it as "very important." The health risks associated with particular methods and protection from sexually transmitted diseases (STDs) are rated as the second most important characteristics by women (each mentioned as "very important" by 77%). In contrast, men consider STD prevention for themselves and their partner to be just as important as pregnancy protection (each mentioned as "very important" by 84-86%), and they rank STD prevention as more important than other health risks (by 72%). Women, but not men, rank both ease of use and the need to plan ahead as being more important characteristics than a method's interference with sexual pleasure. Both men and women have an accurate understanding of the strengths and weaknesses of particular methods, but differ enough in their perceptions to alter the relative attractiveness of each method. In particular, women have more favorable perceptions than men about the pill, being somewhat more likely than men to believe that the pill is "very good" at preventing pregnancy (75% vs. 67%) and to say that it is very good at not interfering with sexual pleasure (82% vs. 76%). In contrast, women have generally less favorable perceptions than men about other reversible methods, including the condom: Women were less likely than men to consider the condom very good at pregnancy prevention (29% vs. 46%) or at having no need for advance planning (22% vs. 38%). Gender differences in perceptions about the specific characteristics of contraceptive methods often vary by marital status. CONCLUSIONS: Men and women have somewhat different priorities when choosing a contraceptive method. Despite many similarities between women and men in their perceptions about the characteristics of each method type, numerous differences between them may have an important influence on how couples make their method choices.

Adult↗
PubMed2005

Reasons for requesting emergency contraception: a survey of 506 Italian women.

OBJECTIVE: To evaluate the reason for requesting emergency contraception (EC), previous use of contraceptive methods and provision route in a Family Planning Clinic in Italy. METHODS: Women requesting EC were interviewed, through a questionnaire containing questions on demographic characteristics, about their reasons for requesting EC, their prior contraceptive use, their reasons for not using an effective contraceptive method (or possible reasons for its failure) and specifically about the so-called 'provision route' (i.e. whether and where they had previously requested EC receiving a negative response). RESULTS: Almost 70% of all women requesting EC were aged between 18 and 25 years. Some 80% of all women were in a stable relationship with their partner, with fewer than 20% having had an occasional intercourse. The vast majority of women (83%) reported prior use of a modern contraceptive method, i.e. 64% with a condom, 27% for combined oral contraceptives and 1.1% for the intrauterine device (IUD). In addition, 15% of the women had used more than one method (oral pills and condoms). Concerning the reasons for requesting EC, condom breakage or slipping was the most frequently cited (64%), followed by totally unprotected intercourse (28%), failed withdrawal (5%) and forgetting one or more pill (only 1.1%). CONCLUSIONS: More than one-third of the women interviewed had previously used an emergency contraceptive modality; although no one did so more than four times. Therefore, it can be inferred that-at least in the present series-EC had not been used as a routine contraceptive method. Finally, it seems clear that in Italy, even in large cities, information about the availability, proper usage and mechanism of action is lacking. This seems due to information being spread by word of mouth between peers and friends, with more formal communication channels lagging behind.

Adolescent↗
PubMed2005

[Is gestagen IUD a realistic alternative to female sterilization?].

INTRODUCTION: For years, female sterilization has been regarded as the most reliable contraceptive method available. However, sterilization is irreversible and requires a surgical procedure. The purpose of our investigation was to see how many women who were offered a reversible, long-term, non-surgical method would prefer it as an alternative to sterilization. MATERIALS AND METHODS: All women referred to our unit for sterilization in the years 2000 and 2001 were offered a consultation in non-operative methods of long-term contraception. All women were offered a levonorgestrel intrauterine system (LNG-IUS) while waiting to be sterilized. The women who chose LNG-IUS were followed for 1-3 years to see if they were later sterilized. RESULTS: Of the 151 women, 14 didn't come in for consultation. Among the 137 remaining women, the primary choice for 69 (50%) was sterilization; 58 women (43%) chose LNG-IUS, and 10 (7%) chose other alternatives. By the end of the observation period, 6 (10%) of the 58 women in the LNG-IUS group had chosen to be sterilized. DISCUSSION: LNG-IUS is a long-term reversible contraceptive method with an efficacy comparable to that of female sterilization. The results suggest that all women referred for sterilization should be counselled about effective alternative methods before proceeding with sterilization.

Adult↗
PubMed2006

Tubal pathology: the role of hormonal contraception, intrauterine device use and Chlamydia trachomatis infection.

BACKGROUND: The aim of the present study was to identify a possible association between tubal pathology and the contraceptive methods previously used, especially third generation copper intrauterine devices (IUDs). METHOD: In this retrospective unmatched case-control study, use of contraceptive methods and Chlamydia trachomatis antibody titres were compared in women with tubal occlusion (n = 84) and infertile women with tubal patency (n = 253) demonstrated by hysterosalpingography. Contraceptive methods were also compared to primiparous women with natural pregnancy. RESULTS: A significantly higher percentage of women with tubal occlusion had previously used an IUD. Positive C. trachomatis antibody testing was found significantly more often in women with tubal occlusion. Neither hormonal contraceptives nor condoms were associated with an increased risk for uni- or bilateral tubal occlusion. CONCLUSION: In the present study, we observed an increased rate of tubal occlusions in previous IUD users. This should be considered in the contraceptive counseling of young and nulliparous women.

Adult↗
PubMed1986

Bacterial flora of the cervix in women using different methods of contraception.

Bacteriologic culture samples were taken from the cervix in three groups of 10 healthy, sexually active women using barrier contraception, oral contraceptives, or a levonorgestrel-releasing intrauterine contraceptive device. Culture samples for Candida albicans and Trichomonas vaginalis were taken, a cytologic vaginal smear was obtained, and an amine sniff test was performed; these were in addition to a routine gynecologic examination. Multiple bacteria were isolated from the cervix in women using oral contraceptives or an intrauterine contraceptive device, whereas lactobacilli alone dominated the flora of women using barrier contraception. Significantly more anaerobic bacteria were isolated from the cervix in oral contraceptive and intrauterine contraceptive device users when compared with the barrier method users. Symptoms and findings evident of anaerobic vaginosis were associated with the occurrence of anaerobic bacteria in the cervix of three patients using the intrauterine contraceptive device. The results showed that the cervical bacterial flora in sexually active healthy women is rich in anaerobes that can be regarded as a normal finding in women using oral contraceptives or intrauterine contraceptive devices. Barrier contraception with a condom prevents this anaerobic shift and maintains a lactobacilli-dominated flora in the cervix.

Adolescent↗
PubMed1995

[Study on risk factors of vaginitis in married women at reproductive ages in rural areas Luliang County, Yunnan Province].

Utilizing data from 2,287 married women at reproductive ages from Luliang county in Yunnan province, a study of prevalence and risk factors of vaginitis was conducted. It is found that the prevalence of vaginitis in Luliang county was 10.2%. The main risk factors selected by Logistic regression were occupation, contraceptive methods used currently, numbers of pregnancies, sexual intercourse per month, habit of washing lower body with dirty water during menses etc. The main risk factors through chi 2-test were age, occupation age of marriage, numbers of pregnancies, numbers of induced abortion, numbers of natural abortion, numbers of stillbirth, numbers of total failing pregnancies, contraception methods used currently, contraception methods ever used before, intercourse per month, wash lower body with dirty water during menses.

Adolescent↗
PubMedDate not supplied

Contraceptive failure in the first two years of use: differences across socioeconomic subgroups.

CONTEXT: While differences in levels of contraceptive use across socioeconomic subgroups of women have narrowed greatly over time, large disparities remain in rates of unintended pregnancy. One reason is variations in the effectiveness with which women and their partners use contraceptive methods. METHODS: Data on contraceptive use and accidental pregnancy from the 1988 and 1995 National Surveys of Family Growth were corrected for abortion underreporting and pooled for analysis. Use-failure rates were estimated for reversible methods during the first year, second year and first two years of use, for subgroups of women of various characteristics. RESULTS: The average failure rate for all reversible methods, adjusted for abortion underreporting, declines from 13% to 8% from the first year of method use to the second year. First-year failure rates are highest among women using spermicides, withdrawal and periodic abstinence (on average, 23-28% in the first year), and lowest for women relying on long-acting methods and oral contraceptives (4-8%). On average, they exceed 10% for all users except women aged 30-44, married women and women in the highest poverty-status category. The chance of accidental pregnancy does not differ significantly between method users younger than 18 and those aged 18-19. CONCLUSION: Both user and method characteristics determine whether contraceptive users will be able to avoid unintended pregnancy. Family planning providers should help clients to identify methods that they are most likely to use successfully, and counsel them on how to be consistent users and to avoid behaviors that contribute to method failure.

Contraception↗
PubMed2004

Diaphragm fitting.

When used with a spermicide, the diaphragm can be a more effective barrier contraceptive than the male condom. The diaphragm allows female-controlled contraception. It also provides moderate protection against sexually transmitted diseases and is less expensive than some contraceptive methods (e.g., oral contraceptive pills). However, diaphragm use is associated with more frequent urinary tract infections. Contraindications to use of a diaphragm include known hypersensitivity to latex (unless the wide seal rim diaphragm is used) or a history of toxic shock syndrome. A diaphragm is fitted properly if the posterior rim rests comfortably in the posterior fornix, the anterior rim rests snugly behind the pubic bone, and the cervix can be felt through the dome of the device. The diaphragm should not be left in the vagina for longer than 24 hours. When the diaphragm is the chosen method of contraception, patient education is key to compliance and effectiveness. An extended visit with the physician or a nurse may be required for a woman to learn proper insertion, removal, and care of the diaphragm.

Anthropometry↗
PubMed2002

Contraception and induced abortion in rural Ghana.

This article describes the results of a community-based survey on birth control in a rural district in western Ghana. Structured interviews with 2179 women and men aged 15-49 years were used to study the prevalence of contraceptive methods and induced abortion. In addition, the influence of induced abortion on reported fertility in relation to residence and education was analysed. The results show that 59.8% had used a contraceptive method at some time in life, while use of induced abortion was reported by 22.6% of respondents. Prevalence of ever-use of any method to avoid childbirth, contraception and/or induced abortion was 67.1%. Urban residence and higher education were associated with more induced abortions and higher use of contraceptive methods. Differences in use of induced abortion were partly responsible for the education and residence-related changes in fertility. Induced abortion needs to be considered when discussing methods in use to avoid childbirth in developing countries.

Abortion, Induced↗
PubMed1991

Longer life span for Copper T 380 A.

Copper T 380 A, the intrauterine device (IUD), has now been clinically approved by the US Food and Drug Administration (FDA) to have a longer lifespan. According to a population council news release, the device, which originally had a 4-year term duration, has been found out to be effective for 6 years. The extension was based on data from a study conducted by the World Health Organization (WHO) and submitted to the FDA by the Population Council, developer of the IUD. This extension will undoubtedly have many advantages, as the less frequently the device is replaced, the fewer the risks of pelvic inflammatory disease, perforation, and other complications that occur mainly soon after insertion. More so, less frequent insertions will cost less and be more convenient. The president of the Population Council, Mr. George Zeidenstein, welcomed the FDA action and said "when we licensed Cynopharma (the sole distributors of the product) to introduce the Copper T 380A IUD in the US 3 years ago, we knew it was a superior, long-acting reversible method that would expand contraceptive options. The fact that this IUD is approved for 6 years makes it an even more attractive option for women choosing a contraceptive method."

Americas↗
PubMed1974

King's termination study. II. Contraceptive practice before and after outpatient termination of pregnancy.

A selection of psychological and social factors present in 360 women who underwent legal termination of pregnancy are related to their contraceptive practice. One-third of the group were ignorant about contraceptive methods, ignorance being more common in women from social classes IV and V and in those under the age of 19. Nearly half of those who had some knowledge of contraceptive practice became pregnant after knowingly taking a risk. A total of 41% had been using some form of contraception immediately before conception. The reliability of contraceptive methods used was found to be inversely related to neuroticism scores obtained from the Eysenck Personality Inventory, neuroticism being highest in women who had not used any form of contraception.Of 91% of the group seen three months after their termination 86% were using reliable contraceptive methods. A follow-up study one or two years after termination has shown that 81% of the 215 women contacted so far are using a reliable method of contraception; two unwanted pregnancies have occurred but both were due to contraceptive failure. This satisfactory outcome has been ascribed to the system of counselling all women before and after termination.

Abortion, Legal↗
PubMed1987

[A case study on the fertility and contraceptive practice of urban women].

"This study analyzes the fertility characteristics and the practise of contraceptive methods among married women aged 15-49 living in Izmit [Turkey] urban area. While the average pregnancies and the number of living children are lower than the average for overall Turkey, the use of contraceptive methods [is] found to be higher. Only [one third] of the women exposed use traditional methods. No significant relation is found between education level or number of living [children] and use of contraceptive methods. 66.5% of all women agree that due to medical or social reasons, legal abortions must be made in hospitals." (SUMMARY IN ENG)

Abortion, Induced↗