Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Contraception Continuation”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 685 records · Page 38Linked to original sources
PubMed2004

Emergency contraceptive pills: a review of the recent literature.

PURPOSE OF REVIEW: The purpose of this review is to inform the reader of new information published since early 2003 about emergency contraception, with a particular focus on issues of access. RECENT FINDINGS: Research continues to document low but increasing levels of knowledge about emergency contraception, increasing use, and more positive attitudes towards emergency contraception by both patients and healthcare providers. Additional information is available about efficacy and mechanisms of action. More reports of side-effects have been published, as have studies relating to the impact of emergency contraception on sexual and contracepting behaviors. Advance provision, provision by pharmacists, and over-the-counter status have been studied as ways to improve access to emergency contraception. SUMMARY: Knowledge about the efficacy, safety, types and use of emergency contraception continues to increase. Although patients have greater awareness of and more access to emergency contraception, there are still numerous barriers to its use even in countries where it is available over the counter. Healthcare providers must continue to educate themselves and their patients about emergency contraception even when it becomes available over the counter. In countries where emergency contraception is only available by prescription, providers should offer an advance prescription or supply (where available), and use newer dosing regimens for levonorgestrel-only emergency contraception to increase adherence and efficacy. Developing collaborative practice agreements with pharmacists to increase access is also recommended. Patients should be counseled to seek follow-up if no menses occurs within 3 weeks of taking emergency contraception or if symptoms such as lower abdominal pain occur after the use of emergency contraception.

Contraceptives, Postcoital↗
PubMed1995

Expression of mRNA for keratinocyte growth factor and its receptor in human endometrium.

BACKGROUND: The aim of the present study was to evaluate the expression of mRNA for the keratinocyte growth factor and the keratinocyte growth factor receptor in human endometrium at different stages of the menstrual cycle. The role of estrogen and progesterone in regulating the expression of the mRNAs encoding keratinocyte growth factor and its receptor was further examined by studying the effect of continuous progestin (endometrium exposed to levonorgestrel releasing intrauterine contraceptive device), and continuous estrogen (endometrium hyperplasia) on the endometrium. METHODS: The expression of mRNA in endometrial samples was evaluated using reverse transcriptase polymerase chain reaction. RESULTS: The expression of KGF mRNA was found to vary during the menstrual cycle, with the highest levels in the progesterone-dominated late-secretory stage endometrium. Keratinocyte growth factor mRNA expression was low in both the endometrium that had been under the influence of continuous progestin (atrophic endometrium) and continuous estrogen (hyperplastic endometrium). The highest level of keratinocyte growth factor receptor mRNA expression was seen in late-proliferative stage of the menstrual cycle and in hyperplasia when the estrogen exposure to endometrium is high. A low receptor mRNA level was found in endometrium exposed to continuous progestin. CONCLUSION: The results suggest that keratinocyte growth factor mRNA expression is progesterone dependent, whereas keratinocyte growth factor receptor mRNA expression seems to be more estrogen than progesterone dependent.

Adult↗
PubMed1995

When is it safe to switch from oral contraceptives to hormonal replacement therapy?

Women may continue to use oral contraceptives (OCs) into their 40's and 50's, but to date no method has been evaluated to ascertain their ovarian status, i.e., whether fertility and estrogen production have diminished sufficiently so they could be safely switched to hormonal replacement therapy. A group of 12 postmenopausal women who had been, for long periods of time, on a regimen of 3 back-to-back packages (i.e., 63 days on, 7 days off) of low-dose oral contraceptives have been studied. Secondly, a group of 9 perimenopausal women aged 36 to 47 were examined in the same manner. The third group consisted of early reproductive age women (arbitrarily divided into subsets aged 17-25 and 26-35 using low-dose OCs in the customary regimen) as normal controls. Blood samples were obtained on the last day of a pill cycle and at 7 days off the pill. In some menopausal women, blood samples were obtained at both 7 and 14 days off OCs. Serum was assayed by RIA for estradiol, FSH and LH. As expected in the young reproductive age women, estradiol levels increase at one week off the pill, together with a rebound in FSH and LH to follicular phase levels. In the perimenopausal group, there was a sharp distinction based on age. The women over 40 showed a more marked rise in FSH while those aged 36-40 showed a distinctly lesser response. Estradiol levels were variable, but tended to show some age grouping. Little diagnostic separation was observed for LH. In postmenopausal women, FSH levels were not always elevated at one week post-pill, and even in a second trial with sampling at one and two weeks off the OC, not all postmenopausal women showed a "menopausal" increase in FSH. The more uniform feature was that estradiol levels never increased above basal values. The study found that serum estradiol levels increase after a week off the pill in controls, but are unchanged at one and two weeks in the menopausal group. FSH levels rebound normally in reproductive age women and usually, but not always, increase substantially in postmenopausal women. After two weeks off OCs, an increased FSH and/or no change in basal estradiol levels is strong evidence that it is now safe (contraceptively speaking) to switch from OCs to standard hormone replacement regimens.

Adolescent↗
PubMedDate not supplied

Oral contraception in Bangladesh.

In rural Bangladesh, the continuation rate of oral contraceptives (OCs) is the lowest among all methods except for condoms, and the pregnancy rate for OC users is comparable to that for users of traditional methods, which lies halfway between that for foam and condom users (high) and Depo-Provera and IUD users (low). To determine why postpartum amenorrheic OC acceptors have shorter pregnancy intervals than postamenorrheic OC acceptors who were matched on time of acceptance as well as on age and parity, subintervals of the pregnancy interval are examined. Results reveal significantly shorter duration of use by amenorrheic acceptors. This short duration of use overrides their significantly longer duration to pregnancy since discontinuation, to give overall shorter duration to pregnancy since last birth.

Adult↗
PubMed2005

Continuous or extended cycle vs. cyclic use of combined oral contraceptives for contraception.

BACKGROUND: The avoidance of menstruation through extended or continuous administration (greater than 28 days of active pills) of combination oral contraceptives (COCs) has gained legitimacy through its use in treating endometriosis, dysmenorrhea, and menstruation-associated symptoms. Avoidance of menstruation through continuous use of COCs for reasons of personal preference may have additional advantages to women, including improved compliance, greater satisfaction, fewer menstrual symptoms, and less menstruation-related absenteeism from work or school. OBJECTIVES: To determine the differences between COCs dosed continuously (greater than 28 days of active pills) compared with traditional cyclic dosing (21 days of active pills and 7 days of placebo). Our hypothesis was that continuously administered COCs have equivalent efficacy and safety but improved bleeding profiles, amenorrhea rates, adherence, continuation, participant satisfaction, and menstrual symptoms compared with cyclic COCs. SEARCH STRATEGY: We searched computerized databases (Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, POPLINE, LILACS) for trials using continuous or extended COCs during the years 1966 to 2005. We also searched the references in review articles and publications identified for inclusion in the protocol. Investigators were contacted regarding additional references. SELECTION CRITERIA: All randomized controlled trials in any language comparing continuous (greater than 28 days of active pills) versus traditional cyclic administration (21 days of active pills and 7 days of placebo) of COCs for contraception. DATA COLLECTION AND ANALYSIS: Titles and abstracts identified from the literature searches were assessed for potential inclusion. Data were extracted onto data collection forms and then entered into RevMan 4.2. Peto odds ratios with 95% confidence intervals were calculated for all outcomes for dichotomous outcomes. Weighted mean difference was calculated for continuous outcomes. The trials were critically appraised by examining the following factors: study design, blinding, randomization method, group allocation concealment, exclusions after randomization, loss to follow-up, and early discontinuation. Because the included trials did not have a standard treatment (type of pill and time length for continuous dosing), we could not aggregate data into meta-analysis. MAIN RESULTS: Six randomized controlled trials met our inclusion criteria. Study findings were similar between 28-day and extended cycles in regard to contraceptive efficacy (i.e., pregnancy rates) and safety profiles. When compliance was reported, no difference between 28-day and extended cycles was found. Participants reported high satisfaction with both dosing regimens, but this was not an outcome universally studied. Overall discontinuation and discontinuation for bleeding problems were not uniformly higher in either group in most studies. The few studies that reported menstrual symptoms found that the extended cycle group fared better in terms of headaches, genital irritation, tiredness, bloating, and menstrual pain. Five out of the six studies found that bleeding patterns were either equivalent between groups or improved with continuous-dosing regimens. Endometrial lining assessments by ultrasound were done in a small number of participants but all endometrial stripe measurements were less than 5 mm. AUTHORS' CONCLUSIONS: Evidence from existing randomized control trials comparing COCs given continuously (greater than 28 days of active pills) to traditional monthly cyclic dosing (21 days of active pills and 7 days of placebo) is of good quality. However, the variations in type of pill and time length for continuous dosing make direct comparisons between regimens impossible. Future studies should choose a previously described type of pill and dosing regimen. More attention needs to be directed towards participant satisfaction and menstruation-associated symptoms.

Contraceptives, Oral, Combined↗
PubMed1980

Contraception in the teenager. A comparison of four methods of contraception in adolescent girls.

The continuation rates, side effects and use-effectiveness of four types of contraceptive were studied during a two-year follow-up period in a group of 160 teenage girls of high socioeconomic standing who hd requested contraception advice. The method of contraception was selected by the girls after a discussion of the alternatives. Results showed good rates of continuation among girls selecting oral contraceptives, the intrauterine device (IUD) and condoms. Side effects and complications preclude the widespread use of oral contraceptives and the IUD in adoescents. There were no serious complications with the use of condoms or vaginal foam, but their use-effectiveness was lower than that of the pill or IUD. The condom is a reasonable alternative for motivated girls. The continuation rate was low in the group selecting the foam method and this form of contraception was quickly abandoned.

Adolescent↗
PubMed1997

Contraceptives for lactating women: a comparative trial of a progesterone-releasing vaginal ring and the copper T 380A IUD.

From approximately one week before normal ovulation resumes, lactating women require protection against pregnancy by a contraceptive that is safe for both infant and mother in a multicenter one-year study, the natural hormone, progesterone, delivered vaginally by a sequence of four contraceptive rings designed for continuous use, was evaluated as a contraceptive for nursing mothers in comparison with the Copper T 380A IUD. Individual rings release in effective average dose of 10 mg day for a 3 month period. Evaluation included measures of lactational performance as well as of contraceptive efficacy and safety to mother and child. Nine participating clinics enrolled 802 ring users and 734 IUD acceptors between postpartum days 29 and 63. Life table analyses were performed with parallel decrements for ring and IUD subjects. Continuation in the study and analysis required that subjects not stop breastfeeding. The ring, with a one-year pregnancy rate of 1.5 per 100, did not differ significantly from the IUD with respect to contraceptive effectiveness (p > 0.05). More than half of the ring subjects were continuing at 6 months post admission and a quarter (23.5 per hundred) were still using the ring and breastfeeding one year after admission. Women with the IUD, however, had higher continuation rates (p < 0.001) at both time points. The largest single decrement for each method was that for weaning. Ring users had more complaints of vaginal problems but had fewer vaginal disorders on examination. At 12 months postpartum, 46 per 100 continuing ring users remained in amenorrhea. Lactation performance and the health and weight gain of the infants were similar among users of either regimen.

Administration, Intravaginal↗
PubMed2002

A survey of recommendations by gynecologists in Canada regarding oral contraceptive use in the perioperative period.

OBJECTIVE: This survey was conducted to determine the practice patterns of gynecologists in Canada regarding the discontinuation of oral contraceptives before gynecologic surgical procedures. STUDY DESIGN: In May and June of 1997, surveys were sent to all obstetricians and gynecologists on the mailing list of the Society of Obstetricians and Gynaecologists of Canada. RESULTS: Of the 1472 surveys that were sent, 702 of the surveys were completed and returned, for a response rate of 48%. More than 90% of the gynecologists who were surveyed would advise their patients to continue using oral contraceptives before relatively minor surgical procedures and <1% of them would use low-dose heparin before these procedures. Rates of oral contraceptive discontinuation increased as the extent of the surgical intervention increased: Prolonged laparoscopy (39.8%), vaginal repairs and hysterectomy (54.7%), and abdominal hysterectomy or adnexectomy (56.1%). Just over one half of the gynecologists (56.1%) indicated that they would advise discontinuation > or =4 weeks before the surgical procedure, which is the minimum time required for the prothrombotic changes that are associated with oral contraceptive use to return to baseline. Less than 10% of the surgeons indicated that they would use low-dose heparin even when the patient was advised to continue taking oral contraceptives before major surgical procedures. CONCLUSION: The controversy over whether young healthy women should discontinue oral contraceptive use before major surgical procedures that are associated with immobility is reflected by a lack of consensus among gynecologists in Canada.

Canada↗
PubMed1982

The effectiveness of contraceptive programs for teenagers.

This paper critically reviews the effectiveness of adolescent family planning programs in the United States. Various models for evaluating family planning programs and the findings from empirical studies of adolescent programs are reviewed. During the past decade there have been major increases in the availability and utilization of contraceptive services by adolescents. Most of those who are sexually active are now aware that these services exist. Program continuation rates among adolescents are not high, in part, because of the sporadic nature of adolescent sexual activity. Data on contraceptive continuation and pregnancy rates in these programs are limited, since few studies follow up clinic noncontinuers. Among clinic continuers pregnancy rates are relatively low, suggesting that at least some programs are effective in reducing pregnancy and/or fertility rates (number of children born) in their target populations. Ecological analyses seem to indicate that programs have had an impact on adolescent marital fertility.

Adolescent↗
PubMed2003

The link between quality of care and contraceptive use.

CONTEXT: Little empirical evidence shows whether quality of family planning care influences continued use of contraception, and if so, to what extent. METHODS: Interviews were conducted in 1997-1998 with 1,728 new family planning users who had sought services at 80 service delivery points in Davao del Norte and Compostela Valley, the Philippines, to assess the quality of care received from family planning services providers. More than 16 months later, 1,460 of the respondents participated in a follow-up survey; the respondents' current contraceptive status was recorded. RESULTS: The quality of care received at the time a woman adopted a contraceptive method influenced her contraceptive use at follow-up, after adjustment for the effects of background characteristics. Furthermore, use increased steadily with quality: The predicted probabilities of contraceptive use were 55% for low-quality care, 62% for medium-quality care and 67% for high-quality care. CONCLUSION: A focus on quality improvement would benefit both programs and users.

Adolescent↗
PubMed1996

Mifepristone: a potential contraceptive.

Use of standard estrogen-progestin contraception remains problematic in several subgroups of patients (e.g., those in whom exogenous estrogens are contraindicated, such as survivors of hormone-dependent cancer, or patients with endometriosis or uterine fibroids). In addition, the postcoital contraception, even if already available, remains at least underused. Additionally, continuous intake of contraceptive steroids is under increasing scrutiny. Would antiprogestins, and specifically the applications of mifepristone such as the ones reviewed in this article offer significant improvements at such problematic occasions? The most attractive novel contraceptive application of mifepristone is that of emergency postcoital contraception after unprotected intercourse. In addition, various options in the endometrial category, specifically those requiring drug administration only during a limited time, might be used in the future. Mifepristone might offer contraceptive and therapeutic relief to patients suffering from endometriosis or uterine fibroids, both conditions that have been shown to benefit from mifepristone therapy. However, the use of mifepristone in contraceptive preparations that are widely available would pose an additional problem of possible misuse of the compound, the reason for currently limiting access to mifepristone. However, such risk should be easily avoidable in the case of postcoital contraception in which only one dose of mifepristone is needed. Regarding the future of mifepristone, and more broadly that of antiprogestins in contraception, the authors believe that they will have a place in the future contraceptive armament. As already emphasized, the strongest clinical areas are those of immediate postcoital and endometrial contraception. Additional studies evaluating parenteral modes of administration, the long-term endometrial effects, and safety and metabolic effects of prolonged antiprogestin administration are needed before mifepristone can be considered a part of the contraceptive arena.

Contraceptive Agents↗
PubMedDate not supplied

[The effect of oral ovulation inhibiting (mono-, bi- and triphase) contraceptives and of Continuin and Postinor on proteo- and steroid hormones].

Endocrinological changes due to the effect of treatment with mono-, bi- and three-phase contraceptive pills taking continuously and occasionally are reviewed. It is established that oral contraceptives based on ovulation inhibition are safe. Less side effects are produced by Ovidon tablets. Continuin and Postinor pills are not safe, and they can produce irregular bleeding. Beside their numerous advances extrauterine pregnancy frequently happens (6.4%). A three-phase preparation is expected to have a reversible effect and lack of a consequent functional infertility. This is improved by hormone level measurements.

Adult↗
PubMed1997

Continuation rates with a levonorgestrel-releasing contraceptive implant (Norplant). A prospective study in Belgium.

Contraceptive protection offered by a method depends on its duration of use, which reflects costs, side effects, and relatives' opinions. This study investigated in Norplant implants users the continuation rates, some of their determinants, and the motives for removals. Since 1988, 612 Norplant implants sets, designed to protect for 5 years, have been inserted. Observing 13,907 months of use, we determined over time the continuation rates and how age, parity, circumstances at insertion (postpartum, postabortum, others), and patronymic origins (surrogate for sociocultural factors) influenced them. Statistics included Kaplan-Meier's method and log rank tests, and uni- and multivariate Cox models. Continuation increased with age and depended on sociocultural factors. Parity exerted influence only in younger women. Median duration of use was 3 years 11 months. Removals before 5 years related almost equally to irregular bleeding, other side effects, and pregnancy wish. The cumulative 5-year failure rate was 1.5%. Unsatisfied users returned earlier, distorting the first results. A literature search showed that implants yield, in the mean, slightly better continuation figures than do intrauterine devices, and clearly higher than those obtained with pills and injectables. To optimize costs and counseling, warnings about the risk of short duration of use in young nullipara, especially if negative sociocultural influences prevail, are recommended. In no category are the implants absolutely to be avoided. Individual and programmatic contraceptive choice should take into account the expected continuation of use.

Adolescent↗
PubMed2004

Changing men's involvement in reproductive health and family planning.

The shift in focus on men's reproductive health was influenced by the 1994 Cairo (ICPD) Action Plan to promote gender equality and equity, empower women, and improve family health in society. Changing and improving the way in which men are involved in reproductive health can only have a positive impact on women's, men's, and children's health. Educating and counseling men about contraceptive choices is essential if they are to be supportive of women's reproductive health. Research on new male contraceptive methods must continue if the bias of women shouldering the major responsibility for contraception is to be eliminated.

Attitude to Health↗
PubMed1996

[Continuity of utilization of a levonorgestrel releasing contraceptive implant: prospective study in Belgium].

Since 1988 we inserted 760 sets of a subcutaneous hormonal contraceptive releasing levonorgestrel active for 5 years. The aim of the study was to investigate the continuation rates. We considered our first 612 insertions. The 5-year cumulative pregnancy rate was 3.7%. The continuation rates were high (50% of the implants remained in situ after 3 1/2 years). These rates increased with age, and were better with European than with non-European subjects (mainly Moroccan and Turkish women). Parity didn't influence. The rates increased over time, because more unhappy women soon came back compared to satisfied users. Removals were related to pregnancy wish, irregular blood loss, end of action, and various side effects. In a few cases untrained physicians removed the implants.

Adult↗