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PubMed2004

[Emergency contraception with levonorgestrel in adolescents].

OBJECTIVE: The aim of the study was to asses effectiveness and adverse reactions in adolescent girls received Postinor (0.75 mg Levonorgestrel) for emergency contraception. METHOD: Forty-two teenage girls with established regular menstrual cycles for 24 months period and 128 intercourses are included. Excluding criteria are: clinical data for gynecological endocrine diseases, other contraceptive methods used and contraindication for using gestagens. The girls received tablets Postinor containing 0.75 mg levonorgestrel in dosage 1 or 2 pills after non-protected sexual contact. Before the study the girls are examined for their knowledge about fertile period of the menstrual cycle, opportunities of hormonal contraception and about their ability to make adequate decisions in unpredicted situations and complications of the unprotected or inadequate protected intercourse. RESULTS: No one pregnancy occurred during the study period. Main first adverse reactions after receiving Postinor were nausea (12.4%) and intermenstrual bleeding (30.9%), persisting up to three days. Systemic adverse reactions reported from the women were breast tenderness (11.2%), dizziness (6.5%) and headache (5.6%). These side effects were mild and did not require treatment. CONCLUSION: Emergency contraception with Levonorgestrel is effective, with less contraindications compared with other emergency contraception methods. Postinor is available and reliable contraceptive medication.

Adolescent↗
PubMedDate not supplied

Choosing and using contraception: toward a theory of women's contraceptive self-care.

Thirty women of varying ethnicity and socioeconomic status, who were actively seeking to avoid pregnancy, were interviewed concerning their lifetime experience with contraceptive use. The resulting description, Women's Contraceptive Self-Care, was divided into four processes: the central process, Choosing and Using Contraception, and three contextual processes. Forestalling Pregnancy was defined as using contraceptive methods or behaviors to prevent or delay childbearing. Assigning the Burden of Contraceptive Responsibility was defined as assuming responsibility for contraception or shifting that responsibility to a partner. Negotiating with Those who Control Contraception was defined as maneuvering among individuals and agencies that permit or hinder access to contraceptive methods and behaviors. Each process is comprised of thematic clusters and/or themes that are defined and illustrated.

Adult↗
PubMed2006

Satisfaction among women: differences between current users of barrier (male condom) and non-barrier methods.

OBJECTIVES: To determine the differences in and factors related to satisfaction between barrier (male condom) and non-barrier method users. METHODS: A semi-structured questionnaire was used for collecting data for this cross-sectional survey. The questionnaires were completed via one-on-one interviews by the researchers. The study group was selected using stratified random sampling. Exclusion criteria were, being unmarried, pregnant, in postmenopausal status and using traditional methods. A total of 434 currently married women using modern contraceptive methods participated in the study. Contraceptive users were dichotomized into two groups as non-barrier method users and barrier method users. RESULTS: About half of the participants (n = 191, 44%) were barrier method users. Their mean age was 33.7 +/- 7.3 years, 66.6% (n = 131) were well educated and reported significantly less pregnancies, given births, living children and abortions (reproductive history events) than non-barrier users. Barrier method users were significantly more likely to be satisfied with their contraceptive method of choice (OR: 2.4; 95% CI 1.2-5.2). Among barrier method users, deciding the type of the contraceptive method themselves had significant effect on satisfaction. CONCLUSION: In our study, satisfaction was mostly affected by heavy side effects and health risks of the methods resulting in less satisfaction with the contraceptive method among non-barrier method users. Other factors which may influence satisfaction deserve further investigation.

Adult↗
PubMed2005

[Reproductive health today].

Sexual and Reproductive Health are considered at present as a Human Right that must be guaranteed by the State. In Argentina some Federal, Provincial and Municipal Laws have been sanctioned in order to guarantee this right through programs that bring information, counselling and implementation in the use of contraceptive methods, prevention, diagnosis and treatment of sexually transmitted infections and genitomammary pathologies. Many Institutions, including Universidad Nacional de Córdoba, have been incorporated in these programs. Contraceptive methods have selection criteria and indication for its use that are described in this publication, for the purpose to explain indications, side-effects, advantages and disadvantages of each one of them; as well as their best usefulness in the three stages of reproductive life: adolescence, sexual maturity and premenopause. Finally, the Eligibility Criteria were synthetized for the use of contraceptive methods, performed by the OMS in 1996.

Contraception↗
PubMed1985

Contraceptive use before tubal sterilization.

A woman's decision to undergo tubal sterilization may be affected by her experience with temporary contraception. To examine this issue we analyzed data from the Collaborative Review of Sterilization, a multicenter, prospective study of the health effects of sterilization operations on women aged 15-44 years. Data on contraceptive use by a comparison group of nonsterilized women were drawn from a random, population-based sample of women aged 20-44 years who were controls in a large study of cancer and steroid hormone use. Sterilized women reported ever using a higher average number of contraceptive methods than did nonsterilized women. As compared with nonsterilized women, a higher percentage of sterilized women reported ever using contraceptives (99% versus 91%), especially two types, barrier and rhythm or withdrawal. Prior to selecting sterilization as a permanent contraceptive method, the sterilized women had more extensive experience with temporary contraceptives, particularly the less effective ones, than did the comparable nonsterilized women.

Adult↗
PubMed2005

[Intention, attitude, subjective norms and perception of control in Spanish adolescents about using Double Dutch].

With adolescence, boys and girls reach their sexual maturity and initiate their sexual encounters. They very frequently adopt risk behaviors as they tend not to use any contraceptive methods. Today's trend in relation to contraceptive methods is to recommend the combined utilization of condom and pill. In comparison to other methods, this last one, known as the Double Dutch (DD) method, has the advantage of preventing pregnancy and STD's, at the same time it increases the efficiency of contraception. Using the Theory of Planned Behavior the purpose of the study was to measure the intention, attitude, subjective norm and perceived behavioral control towards the utilization of the DD method among 15-16 year-old Spanish students and to determine the relationships among these variables. The results indicate that adolescents show favorable intention, attitude and subjective norm toward the utilization of the DD method. They seem to be more worried about pregnancy prevention than about STDs'prevention. Parents seem to be the most important reference people for adolescents, followed by their friends; the results show that at this age, adolescents tend to take into consideration these reference people's opinion.

Adolescent↗
PubMed1999

Barriers to uptake and use of modern methods of contraception in developing countries.

As the next millennium approaches, the current world population of 5.9 billion will continue to increase by 81 million per year -- 93% of which will come from the developing countries. Poor uptake and utilisation of various modern methods of contraception in the developing countries is mainly responsible. In this article, we identify various barriers responsible for the low prevalence of contraceptive uptake in these countries and suggest how these barriers may be eliminated. We conclude that by increasing contraceptive availability and utilisation, population explosion can be significantly controlled.

Contraception↗
PubMed1989

Characteristics of reproductive life and risk of breast cancer in a case-control study of young nulliparous women.

Between 1982 and 1985, a case-control study of nulliparous women, aged 25-45, was conducted to analyse the relationships between the risk of breast cancer and causes of nulliparity, including contraceptive methods. Fifty-one cases of breast cancer diagnosed less than 3 months before interview were matched with 95 controls on age at diagnosis, year of interview, and medical center. The causes of nulliparity related to female sterility or subfertility (mechanical or hormonal disorders) were not found to be associated with a significantly higher risk of breast cancer. The causes related to fertilization failure, i.e. no sexual partner, rare sexual intercourse (less than once per month), or partner with abnormal semen, were found to lead to an increased risk. Detailed analysis of contraceptive methods showed that the risk of breast cancer increased (p = 0.02) with a longer duration of use of barrier methods (withdrawal or condom). Conversely, the risk significantly decreased (p = 0.004) with a longer duration of use of non-barrier methods (oral contraceptives, IUD, cap, local spermicides, vaginal douche, safe period, or no method), i.e. methods allowing a direct exposure to human semen.

Adult↗
PubMed2005

Contraceptive practices and awareness of emergency contraception in educated working women.

BACKGROUND: Regular contraceptive use and emergency contraception are tools to prevent pregnancies. AIMS: This study was designed to investigate knowledge and use of contraceptive methods and awareness of emergency contraception among women working in the hospital. SETTINGS: Educated workingwomen in a medical college hospital. DESIGN: Cross-sectional study. MATERIALS AND METHODS: The study was carried out among women belonging to three categories: staff nurses, ministerial staff and others. Married as well as unmarried employees in the reproductive age group were interviewed. A pretested mixed questionnaire containing open as well as closed ended questions was administered. The women were asked questions concerning knowledge and use of contraceptive methods and awareness of emergency or postcoital contraception. RESULTS: Of the 284 employees 258 women consented for the interview. All the subjects were literate and majority (97.2%) had an urban background. Of the 190 married women, 154 (81.1%) practiced contraception, among them (73.3%) were regular users. Eighty respondents underwent abortions of which 46 had spontaneous and 34 had induced abortions. Among the available contraceptive methods, condom was the most popular method in 89 (57.8%) followed by Copper T in 38 women (24.7%). The use of hormonal contraception was very low 2.6%. Print and electronic media were the common source of public awareness in 149 subjects (57.7%). Twenty-nine women (11.2%) were aware and only three women used emergency contraception. CONCLUSIONS: A high percentage of females in this literate workingwomen population used contraception; however, the awareness of emergency contraception was low.

Adult↗
PubMedDate not supplied

Sterilization and the birth rate.

Sterilization remains irreversible for all practical purposes, but as its procedures become more feasible in developing countries, the question of its potential contribution to fertility decline vis-à-vis other contraceptive methods has increasing significance for family planning program administrators. This question is examined by means of a model that calculates births averted in defined time durations from the acceptance of various contraceptive methods by women of different ages. The findings suggest that without ready access of the population to reversible contraceptive methods that are attractive to birth spacers and tentative birth terminators, the rate of fertility decline is not likely to be satisfactory regardless of the availability, promotion, or popularity of sterilization.

Adolescent↗
PubMed2005

[Knowledge, attitudes and practices about contraception in an urban population].

We studied knowledge, attitudes and practices (KAP) regarding contraception of 1003 married women (aged 15-49 years) randomly recruited from private clinics (490 women) and community clinics (512 women) in Beirut in the year 2000. A standardized KAP questionnaire was administered to the 2 groups and differences between the groups were analysed. Contraceptive methods were used by two-thirds of the women. The private clinics group reported a significantly higher socioeconomic status and educational level than the community clinics group. Despite the free availability of contraceptive methods in the community clinics, the women's level of knowledge of, attitude towards and practice of contraception was significantly lower than those of women in the private clinics. Knowledge, attitudes and practices toward contraception did not depend on the free availability of contraceptive methods but rather on the socioeconomic and educational level of the women.

Adolescent↗
PubMed1995

Sterilisation as a method of contraception: recent trends in Great Britain and their implications.

Data on patterns and trends in sterilisation in Britain among women, men and couples are presented using life table approaches with data from a national survey, the General Household Survey. Among couples under age 50, sterilisation is the main method of contraception used, with slightly more women than men being sterilised, although this is reversed if only contraceptive sterilisation is considered. Trends in contraception have remained relatively constant in recent decades. Patterns of sterilisation differ following births of different orders. For example, the resort to sterilisation is much quicker after a third birth than after a second. The proportions of men and women who have been sterilised and then formed a subsequent partnership are very small, so the effect of sterilisation in preventing births in such unions is negligible.

Adolescent↗
PubMed2006

Knowledge, attitude and practice of natural family planning methods in a population with poor utilisation of modern contraceptives.

Sub-Saharan Africa has one of the highest fertility rates in the world, which is further promoted by the low utilisation of modern contraceptive methods. Yet, many communities claim to have traditional methods of family planning that pre-date the introduction of modern contraceptives, implying that contraception is a culturally acceptable norm. It was therefore postulated that the study population would have a high level of awareness and practice of natural methods of family planning. We aimed to obtain an insight into the extent and correctness of knowledge about natural family planning methods, and its practice as a guide to the general acceptance of contraception as a concept. Pre-tested structured questionnaires were administered to women of childbearing age in households properly numbered for primary healthcare activities. The level of awareness of natural family planning methods was significantly less than awareness for modern methods of contraception. The awareness rate for rhythm method, lactational amenorrhoea method and coitus interruptus was 50.7%, 42.1% and 36.1%, respectively. For all three national family planning methods, there is a steady decline between awareness, correct description of method and utilisation, a difference that was statistically significant in all cases. The sociodemographic factors of the responders had varying influence on utilisation of all three natural family planning methods studied. Rural dwellers practised the lactational amenorrhoea method significantly more often than urban dwellers. Significantly more Muslims than Christians with four children or more practised coitus interruptus or the rhythm method, while the use of lactational amenorrhoea method was significantly increased with the number of living children in both religious groups. There is a relatively low level of awareness of natural family planning methods in the study population, poor utilisation and wrong use of methods. Therefore, improving the correct level of information on natural family planning methods is likely to improve the use of both natural family planning and modern contraceptive methods.

Adolescent↗
PubMed2006

Distribution of contraceptive use in a Turkish population.

OBJECTIVE: This study is designed to estimate the distribution of contraceptive use among reproductive age women in a Turkish population (Turkey). STUDY DESIGN: We included 2365 women of reproductive age in this study. Women were given a questionnaire via a face-to-face interview. RESULTS: During the time period just after marriage, 1914 women (80.9%) declared that they did not use any type of contraception. Among 451 women who had used a contraceptive method just after marriage, the most commonly used method was condoms (34.2%), followed by oral contraceptives (31.2%) and coitus interruptus (25.9%). When their history of contraceptive use was asked, 1903 women (80.2%) stated that they used a method of contraception while 462 women (19.5%) had never used any type of contraceptive. Distribution of contraceptive methods among women was analyzed and intrauterine devices were detected to be the most commonly used method (n=1046, 55%). CONCLUSION: A point that should be emphasized is that there is a marked increase in contraceptive prevalence, and expansion of family planning activities in Turkey. This change, we believe, is due to improvements in health services of Turkey, realized in recent years.

Adult↗
PubMed1987

Epidemiology of contraception with steroids in Western Europe.

A study of contraceptive practice, essential knowledge and communication concerning contraception as well as the related perceptions was conducted among women aged 15-44 in Italy, France, Great Britain, Spain and the Federal Republic of Germany in the years 1984 and 1985. The pattern of contraceptive use and its differential varied strongly between countries. Knowledge, information and communications were observed to be different to a similar degree. Motives for changing contraceptive methods were largely inspired by concern for health and, to a lesser degree, reliability. Perceptions of contraceptive methods were found to be reasonably well in concurrence with reality, with the important exception of the perceptions of the health hazards of the pill which were largely overestimated, giving oral contraception and injustified bad image where effects on health are concerned.

Adolescent↗
PubMed2006

Non-surgical methods of contraception and sterilization.

The Humane Society of the United States estimates that each year between 8 and 10 million dogs and cats enter shelters and 4-5 million of these animals are euthanized due to lack of homes. Many veterinarians within the United States recommend surgical sterilization for population control in dogs and cats. However, there are non-surgical methods to control reproduction. Pharmacologic methods of contraception and sterilization can be safe, reliable and reversible. Hormonal treatments using progestins, androgens, or gonadotropin releasing hormone (GnRH) analogs act to either directly block reproductive hormone receptor-mediated events, or indirectly block conception via negative feedback mechanisms. Immunocontraception, via vaccination against GnRH, the luteinizing hormone receptor or zona pellucida proteins, is also possible. Intratesticular or intraepididymal injections provide a method for non-surgical sterilization of the male dog and cat. Additional methods have been employed for mechanical disruption of fertility including intravaginal and intrauterine devices and ultrasound testicular ablation. Alternative approaches to surgical sterilization will be reviewed.

Animals↗
PubMed2004

Norplant insertions at the Zeynep Kamil Gynecologic and Pediatric Training Research Hospital in Istanbul.

OBJECTIVE: This study was conducted to determine sociodemographic characteristics and usage interval according to insertion period, observed side effects and reasons for discontinuation in 756 cases where Norplant was inserted and removed for any reasons at our hospital since 1994. METHODS: Seven-hundred and fifty-six cases in whom Norplant was inserted and removed since 1994 were included in our study. Sociodemographic characteristics, former contraception method, reasons for choosing this method and side effects seen during the usage period were determined. In all cases, reasons for discontinuation, sociodemographic characteristics and usage interval according to the insertion period were investigated. Statistical analysis of this study was performed with SPSS 9.0 (analysis of variance). RESULTS: Mean age of cases was 26.5 +/- 4.9 years, mean number of living children was 2.0 +/- 1.2, and 50.4% of cases had no health insurance. Most of the cases used coitus interruptus previously as a contraceptive method and chose Norplant use because of its effectiveness. Insertion periods were as follows: interval, n = 513 (67.9%); postpartum, n = 127 (16.8%) and postabortion, n = 116 (15.3%). Various side effects were detected in 79.8% of the cases. Bleeding problems were seen in 69.8%. Pregnancy occurred in only one case. Mean Norplant usage interval was 3.08 +/- 1.68 years. The longer usage interval was seen in cases with lower educational level. When we compared the usage intervals between interval, postpartum and postabortion periods, we found that the interval group had a shorter mean duration of Norplant use. Discontinuation because of bleeding problems occurred in 38.1%. Removal of all Norplant implants was performed at a single session in 731 cases (96.4%). After Norplant removal, most cases selected either condom or IUD as the contraceptive method. CONCLUSION: It is concluded that despite the frequent occurrence of side effects, Norplant is a modern, long-acting, highly effective, reversible, easy-to-use, satisfactory form of birth control, especially in selected cases.

Adult↗
PubMed1996

Post-partum contraception.

The choice of a post-partum contraceptive method depends on many factors, including the need for a temporary versus a permanent method, the infant feeding choice and the extent to which informed consent is made prior to delivery. For maximum protection, the non-breast-feeding woman should be protected from the fourth week post-partum, even if that means using a temporary method, such as condoms or spermicides, until her method of choice is procured. Combined oestrogen/progestin methods should be avoided by all women for 2-3 weeks to avoid elevating the risk of thromboembolism. Preparations containing oestrogen should be avoided altogether during lactation because they have been associated with a reduction in milk production. POPs, implants and injectables are appropriate regardless of infant feeding choice. They can be administered immediately post-partum in bottle-feeding women, but should ideally be postponed for 6 weeks in breast-feeding women. It is best to insert IUDs within 10 minutes of delivery of the placenta, in order to minimize the risk of IUD expulsion. Insertion immediately after expulsion of the placenta requires special training, and expulsion rates are reduced with the insertion experience of the practitioner. Breast-feeding is not associated with an increase in IUD expulsion or uterine perforation, and it is associated with fewer removals for bleeding or pain. Tubal sterilization is safe, convenient and cost-effective when performed immediately after delivery, but it requires extensive counselling and fully informed consent prior to the onset of labour to avoid potential regret over post-partum tubal ligation. If the procedure is performed immediately, any effect on the establishment of lactation may be minimized. LAM is a method that can only be used by breast-feeding women. It may prove to be a useful way to time the commencement of a second, less temporary contraceptive method. Natural family planning methods require a period of abstinence for the establishment and identification of the new symptoms of fertility. When LAM is used during this interval, the need for abstinence may be reduced significantly for breast-feeding women. Breast-feeding provides health benefits for the woman and her infant, as well as the best possible nutrition for the baby. The International Planned Parenthood Federation (1990) (among others) recommends that, 'As far as is practicable, all women should be advised and encouraged to breastfeed fully'. The infant feeding decision affects the choice of a contraceptive method, and this is an important reason for the woman's physician to be interested in her infant feeding choice.

Breast Feeding↗